Insurance & Reinsurance

Transform Insurance Workflows
with Human-in-the-Loop AI Solutions

Your claims adjusters are re-keying FNOL data into the TPA platform. Your underwriters are manually parsing ACORD forms, loss runs, and SOVs into the policy admin system. Your ops team is reconciling bordereaux in Excel while your combined ratio keeps climbing. Practical builds AI that plugs directly into these workflows -- with a human in the loop at every decision point -- so your people spend their time on judgment calls, not data entry.

FNOL First Notice of LossTPA Third-Party AdministratorACORD Association for Cooperative Operations Research and DevelopmentSOV Statement of Values
5x
Faster Claims Processing
40%
Reduction in Claims Leakage
80%
Straight-Through Processing
99.5%
Data Extraction Accuracy

* We propose our solution free of charge, with no hidden fees or commitments.

Key Use Cases

Key Use Cases

These are the workflows where carriers, MGAs, and TPAs are burning the most hours on manual work that should have been automated years ago. Each one is built with human oversight baked in -- your adjusters approve, your auditors can trace every step.

Claims Processing & FNOL Automation

Your adjusters are spending 20-30 minutes per claim just re-keying FNOL data into the claims system. A policyholder reports a loss, attaches photos and a police report, and someone on your team manually enters all of it into Guidewire or Duck Creek field by field. We extract every detail from the FNOL submission, validate coverage against the policy, run initial reserve estimates, and flag SIU indicators -- so your adjusters focus on investigation and settlement, not data entry. Straight-through processing handles 65% of low-complexity claims end-to-end.

FNOL First Notice of LossSIU Special Investigations Unit
Claims Flow
Live System
Step 1FNOL Intake
New Claim Received
CLM-2025-48291
• Extracting loss details from FNOL report
• Parsing police report & photos
• Matching to policy PL-00482910
Step 2AI Triage
Running Checks
In Progress
Coverage Verification
Fraud Indicator Scan
Reserve Estimation
Step 3Results
Fast-Track
• Low complexity
• No fraud flags
• Within authority
65% of claims
Adjuster Review
• Complex liability
• High severity
• SIU referral
35% of claims
Submission Flow
Live System
Step 1Document Input
ACORD 125
Loss Runs
SOVs
Step 2AI Processing
Extracting Submission Data
• Parsing ACORD form fields
• Analyzing 5-year loss history
• Scoring risk against guidelines
Step 3Results
Submission Analyzed
3.2s
Risk ScoreModerate (54/100)
• 12 fields auto-extracted from ACORD
• Loss ratio: 62% (within appetite)

Underwriting Submission Review

A broker sends in an ACORD 125 with five years of loss runs, three SOVs, and a supplemental application -- and your underwriter spends 30-60 minutes manually keying that into the underwriting workbench. Meanwhile, 40% of submissions get declined anyway because they're outside appetite. We parse every ACORD form field, extract and normalize loss run data, score the submission against your underwriting guidelines, and surface only the accounts that fit your book. Your underwriters spend their time on pricing and negotiation, not data entry and triage.

ACORD Industry-Standard Insurance FormsSOV Statement of Values

Policy Document Processing

Renewal season hits and your team is drowning in 47-page policy documents, comparing endorsement schedules line by line, checking whether sub-limits changed, verifying that the dec page matches the quote. One missed exclusion change costs you a coverage dispute down the line. We ingest the full policy package, extract every endorsement, exclusion, and coverage term, compare it against the prior year or the broker's requested terms, and flag every material change. Your policy analysts review a clean summary instead of reading 50 pages of ISO forms.

ISO Insurance Services OfficeDec Page Declarations Page
Policy Flow
Live System
Step 1Document Input
Renewal_Package_Q2.pdf
Processing 47-page policy...
Step 2AI Comparison
Comparing Terms
82% Complete
Endorsement Extraction
Exclusion Mapping
Limit/Deductible Comparison
Step 3Output
Analysis Complete
1.8s
Changes Detected14 material changes
• 3 new exclusions flagged
• Sub-limit reduced on cyber coverage
Call Flow
Live System
Step 1Call Reception
Incoming Call
+1 (555) 871-3924
• Loading policyholder profile
• Pulling active claims history
• Checking renewal status
Step 2Voice Analysis
Real-time Processing00:38
Speech Recognition
Intent Detection
Policy Lookup
Step 3AI Response
Response Generated
High Confidence
• Issue: Claim Status Inquiry
• Sentiment: Concerned
• Action: Providing Claim Update
• Next: Scheduling Adjuster Call

AI Call Center for Policyholder Support

Most of your inbound call volume is the same 15 questions -- claim status updates, ID card requests, payment due dates, coverage verification letters, address changes. Your CSRs are handling routine requests that don't need a human. We deploy voice AI that resolves these tier-1 calls end-to-end, pulls up the policyholder's coverage and claims history in real time, and seamlessly escalates to a live agent the moment something requires actual judgment -- a complex claim, a coverage dispute, a cancellation save. Your hold times drop, your CSAT goes up, and your experienced staff handles the calls that actually matter.

CSAT Customer Satisfaction ScoreCSR Customer Service Representative

Fraud Detection & SIU Triage

Claims leakage from undetected fraud costs the average carrier 5-10% of incurred losses. Your SIU team is overwhelmed with referrals, most of which are false positives, while genuinely suspicious claims slip through because the red flags were buried in adjuster notes nobody had time to read. We score every claim against 40+ fraud indicators in real time -- prior claim patterns, provider network anomalies, photo metadata inconsistencies, claimant relationship mapping -- and surface only the cases that warrant a full SIU investigation. Your investigators focus on confirmed high-risk referrals instead of chasing noise.

SIU Special Investigations Unit
SIU Flow
Live System
Step 1Claim Flagged
Suspicious Claim Detected
• Claim: CLM-2025-91204
• Type: Water damage - $48,000
• Flag: Prior similar claim 8 months ago
Step 2AI Analysis
Running Indicators
In Progress
Claim History Check
Photo Metadata Analysis
Network Link Analysis
Step 3SIU Decision
Ready for Review
SIU-REF-482
• Fraud score: 78/100 (High)
• 3 red flags identified
• Recommended: Full investigation

Enterprise-Grade Security & Compliance

End-to-End Encryption

TLS 1.3 in transit, AES-256 at rest. Policyholder PII and claims data never leaves your approved environment without explicit authorization.

Access Controls

Role-based permissions tied to your org structure. Adjusters see claims data, underwriters see submissions -- no cross-contamination of sensitive information.

Audit Trails

Every action, every decision, every override -- timestamped and immutable. Ready for your next DOI market conduct exam or reinsurer audit.

Data Privacy

Full compliance with state privacy regulations and NAIC data security model law requirements for policyholder information.

Claims Data Isolation

Carrier-level data segregation ensures your claims intelligence and underwriting models remain proprietary and protected.

Regulatory Compliance

Built to satisfy DOI examination requirements, reinsurance treaty audit provisions, and state-specific claims handling regulations.

Implementation Process

How We Work

We don't do six-month discovery phases. Here's how we go from first conversation to live production in weeks.

01

Discovery & On-Site Assessment

We come on-site, shadow your claims and underwriting teams, and map the exact workflows where manual effort is dragging down your combined ratio. We deliver a detailed proposal with projected ROI -- free of charge, no strings attached.

02

Approval & Development

Once you greenlight the plan, we build and fine-tune the AI against your actual policy forms, your claims data formats, your specific underwriting guidelines, and the terminology your teams actually use -- not generic insurance data.

03

Integration & Testing

We integrate via API into your existing systems -- your claims platform, policy admin system, underwriting workbench -- and run real production data through the system until accuracy and stability meet your standards.

04

Go Live & Continuous Improvement

The system goes live and improves with every claim and submission it processes. You get real-time dashboards showing throughput, accuracy, and exception rates, plus full audit logs for DOI examiners and reinsurance auditors.

Enterprise-Ready Solution

Stop Paying for Manual Work That Should Be Automated

We'll assess your claims, underwriting, and policy workflows on-site, show you exactly where the hours are going, and build a solution scoped to your systems. The assessment is free -- no commitment, no sales pitch.

5x
FASTER CLAIMS
40%
LESS LEAKAGE
80%
STP RATE
99.5%
ACCURACY RATE