Agentic AI
Coordinate AI agents across the full claims lifecycle, from first notification of loss to settlement, with no handoff gaps, consistent decisions and full auditability.
A coordinated system of AI agents that handles the complete claims lifecycle: intake, document processing, assessment, and adjudication, without manual handoffs between steps.
Each agent specialises in its task and passes structured, validated outputs to the next. The result is faster cycle times, fewer touch points, lower leakage and a consistent, auditable decision record from FNOL to settlement.
Faster Intake. Leaner Operations. Lower Leakage.
Claims FNOL and Intake
Conversational AI agents capture, validate and structure claim reports 24/7, across voice, text, photo and video, in any language. Incomplete submissions are followed up automatically until all required data is collected.
Assessment and Checks
Assessor agents apply your policy rules and benefit schedules, verify coverage, score the claim and surface fraud, waste and abuse indicators, with a structured evidence chain citing every rule triggered and every source document referenced.
Closed-Loop Improvement
Human reviewer decisions (approvals, modifications and overrides) feed back into agent rule sets and scoring models through a continuous improvement cycle. The system improves with every claim handled.
Document Processing
IDP agents extract, classify and validate claims documents (medical reports, invoices, police reports, discharge summaries) with up to 99% accuracy and per-field confidence scoring. Code mapping, for example ICD-10 and cause-of-loss codes, is automated.
Adjudication and Routing
Structured assessment outputs route cases to automated approval, referral queue or human review based on configurable risk thresholds, with full routing justification logged for audit.
Configured to Your Rules and Requirements. Ready from Day One.
Built for Regulated Claims Environments
Full Audit Trail
Every agent action, rule triggered, document extracted, decision made and routing applied is logged end-to-end, for compliance, reporting and dispute resolution.
Human-in-the-Loop
Explainable Decisions
Every assessment output includes an evidence chain with citations back to policy rules, benefit schedules and source documents, supporting fair-treatment obligations and regulatory review.
EU AI Act Ready
Explainable, traceable and human-supervised by design, the agentic claims solutions are checked to deliver the requirements under the EU AI Act and equivalent frameworks before deployment.
