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In productionLess handling time + better service
AI Agent for Insurance Claim Settlements
Health and medical insurer
Turn claim documents into payout recommendations for adjuster review.
Project highlight
~70% lower handling time
Reported project outcome: average claim handling time fell from 10 minutes to 3.
The business challenge
Claims were assessed by hand. Policyholders waited days for a decision while adjusters carried heavy, repetitive caseloads where small errors were easy to make.
What we delivered
- A claims engine that accepts the policy, doctor summaries, invoices, and supporting paperwork.
- A workflow that follows the insurer’s own claims-processing procedure.
- A recommendation layer that prepares the proposed payout for adjuster review.
Business impact
Less handling time per claim gives adjusters more capacity and helps policyholders receive decisions sooner. Consistent recommendations support a more efficient claims process.