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GrahAI Systems
Professional AI Services Hub

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

1

Claims triage agent

Reads the full FNOL bundle — forms, photos, estimates — and routes each claim with a structured summary and missing-document checklist.

2

Underwriting copilot

Extracts risk factors, checks them against appetite and guidelines, and drafts an auditable rationale for the underwriter.

3

Fraud-signal scorer

Flags claims against known fraud patterns and network links with an explanation an investigator can verify.

4

Policy-document RAG

Answers agent and customer questions grounded in actual policy wordings, endorsements and exclusions with citations.

5

Subrogation finder

Scans closed claims to surface missed recovery opportunities and drafts the supporting case file.

6

Renewal & retention assistant

Identifies at-risk policies and drafts personalized retention outreach for the servicing team to approve.

How we deliver

Capability ParameterSystem Specification
IntegrationsCore policy admin, claims systems, document management, IRDAI/regulator reporting feeds
ModelsFrontier LLMs for document reasoning; tuned scoring models for fraud and risk signals
GuardrailsExplainable decisions, bias testing, human approval on every claim and underwriting outcome
EngagementFixed-scope build, 4–10 weeks, then optional operate retainer
Typical budget₹20L–₹50L / $20k–$60k per production system
Data & complianceRegulator-aligned audit trails; PII protection; fairness and explainability documentation

Frequently Asked Questions

Let's Build Your AI System

Whether you need an AI chatbot, workflow automation, document intelligence platform, or a complete custom AI SaaS product, our product engineers can build it.

Book Free Discovery Call
Or write to us directlysupport@grahai.com

Bengaluru, Karnataka, India