Claims Processing Automation Software
Let your AI agent handle tedious claim reviews, data validation, and settlement prep—so you can focus on complex cases and client communication.
You spend hours each week as a claims adjuster digging through Excel files, Outlook threads, and scanned PDFs just to verify coverage and process payments. Managing investigations with SharePoint folders and endless email chains leaves you scrambling to meet deadlines and increases the risk of errors.
An AI agent that handles claim review, investigation, and settlement tasks for insurance adjusters, reducing manual work and speeding up resolutions.
What this replaces
The hidden cost
What this is really costing you
In the financial services industry, claims adjusters and examiners often waste 20-25 hours a week reviewing claim forms, verifying policy details in Guidewire or Duck Creek, and cross-checking supporting documents in Outlook and shared drives. Every step—summarizing findings, processing payments, and updating claim status—requires tedious manual effort. This repetitive work slows down settlements and distracts you from handling complex or disputed cases.
Time wasted
24 hrs/week
Every week, burned on work an AI agent handles in minutes.
Money lost
$36,000/year
In salary, missed revenue, and operational drag — annually.
If you keep ignoring it
Delays in manual claims processing lead to frustrated policyholders, increased backlog, and potential compliance issues with state insurance regulations.
Cost estimates derived from U.S. Bureau of Labor Statistics occupational wage data and O*NET task analysis.
Return on investment
The math speaks for itself
Today — without agent
24 hrs/week
of manual work
With your AI agent
5 hrs/week
agent-handled
You save
$28,500/year
every year, reinvested into growing your business
Estimates based on U.S. Bureau of Labor Statistics median salary data and O*NET task importance ratings from worker surveys. Time savings assume 80% automation of eligible task components.
Jobs your agent handles
What this agent does for you
Complete jobs, handled end-to-end — so your team focuses on what matters.
Coverage Verification
You ask your agent to review a new claim submission and summarize which coverages apply, highlighting any missing or unclear information.
Complex Claim Investigation
You ask your agent to analyze police reports, medical records, and property estimates to recommend a settlement decision for a disputed claim.
Payment Processing
You ask your agent to process approved claims, generate payment records, and update the claim file with all necessary documentation.
Flagging Questionable Claims
You ask your agent to review recent claims and flag any that show irregularities or require further investigation.
How to hire your agent
Connect your tools
Link your claims management, bill review, and document storage systems to the agent for seamless data access.
Tell your agent what you need
Type: 'Review this claim file, verify coverage, and summarize any missing documents or discrepancies.'
Agent gets it done
The agent returns a detailed coverage summary, lists missing items, and flags any inconsistencies for your review.
You doing it vs. your agent doing it
Agent skill set
What this agent knows how to do
Claims Data Extraction
Pulls claim details from Guidewire or Duck Creek, compiles all relevant records, and generates a summary for quick review.
Coverage Verification
Checks policy limits and coverage terms against submitted claims, highlighting missing or unclear information for follow-up.
Investigation Summary Creation
Reviews police reports, medical records, and photo evidence to draft investigation findings and recommend next steps.
Payment Processing Support
Prepares payment documentation, updates claim status in your core system, and logs all transactions for audit trails.
Fraud Detection
Flags suspicious patterns by analyzing claim histories and inconsistencies in supporting documents.
Correspondence Summarization
Compiles key points from claimant and witness emails into concise summaries for faster decision-making.
AI Agent FAQ
Your AI agent integrates with Guidewire, Duck Creek, and OneDrive via secure API connections. You can upload files directly or link cloud storage for document access.
All data is encrypted in transit with TLS 1.3 and never stored after processing. Every action is logged for compliance, and you control which files are shared.
No, the AI agent handles repetitive tasks like data extraction and summary preparation, but you review all recommendations and make final decisions.
The agent reviews property, auto, and liability claims in English. Multi-language support and specialty lines are on the roadmap.
Most claim reviews and payment prep are completed within minutes. More complex investigations may take up to an hour, depending on file size.
Yes, your AI agent is purpose-built for automating claim reviews, investigation summaries, and payment processing in the insurance industry.
Automatable tasks
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