Industries · Insurance
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.
How It Works
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.
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.
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.
Capabilities
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.
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.
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.
Handles policy lookup, coverage questions, mid-term adjustments, and certificate requests across digital channels — resolving the majority of policyholder service requests without agent involvement.
Monitors filing deadlines, extracts required data from policy and claims systems, and generates formatted submissions for state insurance department filings — reducing compliance operations overhead.
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 AI Practice
By Industry
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