Industries · Insurance

AI agents for insurance. Claims to compliance. Azure-native.

Intelligent agents that triage claims automatically, detect fraud before payment, automate underwriting document review, and keep policyholders served without growing your operations headcount. Built on Azure with full regulatory audit trail.

71%
claims auto-triaged
18 hrs
avg processing (was 6 days)
64%
fraud detection improvement
$1.4M
ops savings/year

How It Works

From FNOL to adjuster-ready summary — in under two minutes.

01

Policy & Claims Data Integration

We connect the agent to your core insurance systems — policy administration, claims management, and document repositories — via Azure API Management and Azure AI Document Intelligence, with Entra ID governing access.

  • Policy administration and claims system API connectors
  • Azure AI Document Intelligence for FNOL and supporting document processing
  • Microsoft Entra ID for role-based data access governance
02

Intelligent Claims & Risk Analysis

Azure OpenAI extracts structured data from unstructured claims documents, while Azure Machine Learning applies fraud and risk models — generating adjuster-ready summaries and decision support outputs in seconds.

  • Azure ML for fraud scoring and renewal propensity models
  • Azure OpenAI for claims narrative analysis and coverage matching
  • Azure AI Search for policy document retrieval at claim time
03

Decision Routing & Compliance Logging

Straight-through-processable claims are automatically resolved with full audit trail. Complex cases are routed with AI-generated summaries. Every decision is logged in Azure Monitor for regulatory defensibility.

  • Configurable straight-through processing thresholds
  • Adjuster-ready claim summary generation
  • Immutable decision audit log in Azure Monitor

Capabilities

What the agent handles across insurance operations.

Claims Triage & Routing

Automatically classifies incoming claims by type, complexity, and fraud risk — routing straight-through-processable claims directly to payment and escalating complex or suspicious cases to the appropriate adjuster queue.

Underwriting Automation

Extracts risk factors from application documents, medical records, property surveys, and third-party data sources — generating structured risk summaries and preliminary underwriting recommendations for review.

Fraud Detection

Applies network analysis, anomaly detection, and pattern matching across claims history, claimant relationships, and external fraud indicator databases — flagging suspicious claims before payment is released.

Policy Servicing Chatbot

Handles policy lookup, coverage questions, mid-term adjustments, and certificate requests across digital channels — resolving the majority of policyholder service requests without agent involvement.

Regulatory Filing Automation

Monitors filing deadlines, extracts required data from policy and claims systems, and generates formatted submissions for state insurance department filings — reducing compliance operations overhead.

Renewal Propensity Scoring

Analyses policyholder behaviour signals, claims history, payment patterns, and market data to score renewal likelihood — enabling proactive retention outreach focused on the accounts most at risk of lapsing.

Built With

Azure technology stack

Azure OpenAIAzure AI Document IntelligenceAzure Machine LearningAzure AI SearchAzure API ManagementMicrosoft Entra ID

Process more claims. Detect more fraud. Spend less on ops.

Insurance AI agents on Azure. Full audit trail. Regulatory-ready. Deployed in 4 weeks.