AI for insurers: claims intake, documents and back office
Insurance runs on paperwork: claims, surveys, repair invoices, medical reports. We build AI that turns that pile into a ready case file, so adjusters spend time on decisions instead of retyping scans.
Typical tasks
- 01First notice of loss intake
Customers report a claim through chat, WhatsApp, a web form or by phone. The AI collects mandatory fields, checks the document set and opens a case in your system. It asks for anything missing straight away.
- 02Claims document processing
The AI reads policies, survey reports, repair invoices and medical certificates. Data lands in the right fields, and uncertain values are highlighted. Staff only review what the model is unsure about.
- 03Back-office agent
The agent checks a claim against policy terms, limits and deductibles. It drafts the decision and the letter to the customer. A person signs and sends.
- 04Claims fraud signals
The model looks for reused photos, repeat garages and suspicious overlaps in dates and parties. It adds a risk flag with an explanation. Your investigations team decides.
- 05Policyholder and broker support
Chat and voice agents answer questions on claim status, renewals and required documents. Complex cases go to an agent with the full history attached.
- 06Call quality review
Our own LLM reviews sales and service calls. You see promises that should not have been made and where customers were unhappy.
Data and access requirements
- Insurance regulation: Solvency II governance, IDD conduct rules and your national supervisor. We document intake and claims logic so it can be shown in an audit.
- Health data in life and medical lines is special category data under GDPR. We use separate roles, encryption and processing on dedicated servers.
- EU AI Act: risk assessment and pricing for individuals in life and health insurance are listed as high-risk, so human oversight and logging are designed in.
- Integration with your policy administration system, claims platform and ERP such as SAP or Odoo through API.
What we build for this industry
Questions
Can the AI approve payouts on its own?
No. The AI prepares the case, calculates the amount under the policy terms and proposes a decision. An adjuster approves. This lowers risk and makes the decision easy to explain to the customer and the regulator.
Which documents can it read?
Policies, claim forms, survey reports, repair estimates, medical certificates and damage photos. We tune the model on real samples of your forms during discovery. Handwriting is read less reliably, so those documents keep a manual check.
How much does it cost?
Turnkey projects start at $5,000. The price depends on document types, integrations and channels. After discovery you get a fixed estimate in 2-3 days. If we exceed it through our fault, we finish at our own cost.
How is policyholder data protected?
NDA and DPA are signed before access. We work under ISO/IEC 27001:2022, and documents are processed by our own LLM on our or your servers. Third-party models never see the data.
Describe the task. The first call is with the founder.
We reply within one business day. 30 minutes to tell you whether it is worth doing and what it costs.