AI for insurance that pays the right claims
Claims triage, underwriting copilots and fraud-signal detection — built with the auditability and fairness controls a regulated insurer needs.
Where AI actually moves the needle in Insurance
Insurance runs on documents and judgment under uncertainty. Claims arrive as a chaotic bundle — FNOL forms, photos, repair estimates, medical reports — and the first job is triage: route the simple ones to fast-track, flag the suspicious ones, and surface the missing documents. An agent that reads the whole bundle and produces a structured summary with a recommended path saves adjusters from hours of intake work.
Underwriting is the other lever. A copilot that pulls risk factors from application data and external sources, checks them against your appetite and guidelines, and drafts a rationale lets underwriters spend their time on the genuinely ambiguous cases. Done right, it improves consistency and leaves an auditable trail of why a decision was made — which regulators and reinsurers both want.
Fraud is a pattern problem, not a magic detector. We build systems that score claims against known fraud signals and network patterns, then explain the why so a human investigator can act. Across claims, underwriting and policy servicing we keep every model decision explainable and bias-tested, because in insurance an opaque or unfair model is a liability, not an asset.
What we build for Insurance teams
Claims triage agent
Reads the full FNOL bundle — forms, photos, estimates — and routes each claim with a structured summary and missing-document checklist.
Underwriting copilot
Extracts risk factors, checks them against appetite and guidelines, and drafts an auditable rationale for the underwriter.
Fraud-signal scorer
Flags claims against known fraud patterns and network links with an explanation an investigator can verify.
Policy-document RAG
Answers agent and customer questions grounded in actual policy wordings, endorsements and exclusions with citations.
Subrogation finder
Scans closed claims to surface missed recovery opportunities and drafts the supporting case file.
Renewal & retention assistant
Identifies at-risk policies and drafts personalized retention outreach for the servicing team to approve.
How we deliver
| Capability Parameter | System Specification |
|---|---|
| Integrations | Core policy admin, claims systems, document management, IRDAI/regulator reporting feeds |
| Models | Frontier LLMs for document reasoning; tuned scoring models for fraud and risk signals |
| Guardrails | Explainable decisions, bias testing, human approval on every claim and underwriting outcome |
| Engagement | Fixed-scope build, 4–10 weeks, then optional operate retainer |
| Typical budget | ₹20L–₹50L / $20k–$60k per production system |
| Data & compliance | Regulator-aligned audit trails; PII protection; fairness and explainability documentation |
