Claims triage copilot
An agent that reads incoming claims, cross-references policy data, and routes high-risk cases to adjusters.
This is an illustrative example of the kind of engagement our services cover, not a case study from a named client.
The Challenge
Claims volume was growing faster than the adjuster team, and manual first-pass review was creating a backlog on exactly the cases that needed the fastest attention.
Our Approach
We built a retrieval-augmented agent that reads incoming claims against policy documents and historical patterns, flags anomalies, and routes high-risk or high-value claims straight to a senior adjuster with the relevant context attached.
The Outcome
Manual first-pass review time dropped significantly, and adjusters spend their time on the claims that actually need judgment instead of triage.
Ready to put AI to work on your data?
Tell us about the process you want to transform. We'll map out where AI can move the needle fastest.