AI Agent
Agente AI de reclamaciones de seguros
Process claims in minutes instead of days
45-minute average claim processing time. Now: under 2 minutes with 98% straight-through processing.
Benefits
Transform Claims from Bottleneck to Competitive Advantage
Manual claims processing creates multi-day backlogs and frustrated policyholders. Staff review every claim line-by-line. Simple claims take as long as complex ones. This agent automates everything.
98%
Straight-through processing
<2min
Average claim time
60%
Cost per claim
Agentic Flows
End-to-End Claims Automation
Automated workflow: claim intake from FNOL or submission, data extraction and validation, coverage verification against policy, fraud detection screening, adjudication with payment calculation, payment processing.

How it works
Intelligent Claims Adjudication
The agent extracts claim data using OCR and structured formats, validates against policy terms and coverage limits automatically, detects fraud patterns and flags suspicious claims, adjudicates and pays approved claims.
Integrations
Works with Insurance Core Systems
Direct integration with Guidewire, Duck Creek, Majesco, and Insurity policy and claims systems. Connects to ISO ClaimSearch, LexisNexis, and SIU tools for fraud detection. Payment via banking platforms.
Implementation
Processing Claims in 2 Weeks
Connect your policy and claims management systems. Configure adjudication rules and fraud thresholds. Most carriers process automated claims within 14 days of deployment.
Key Features
Advanced Claims Processing
Auto Adjudication
Validates coverage, applies deductibles, calculates benefits. Pays clean claims automatically.

Fraud Detection
ML models detect suspicious patterns and known fraud indicators. Routes flagged claims to SIU.

Subrogation Management
Identifies potential recovery opportunities. Initiates subrogation workflow with documentation.


