Industries // Insurance
INSURANCE
SOFTWARE.
We build the systems that move claims from FNOL to payment without manual re-keying.
// The Problem
Most carriers still run claims on a patchwork of legacy policy admin systems, spreadsheet-based reserves tracking, and manual document review. The average property casualty claim touches 7 different systems before it closes. Adjusters spend 40% of their time on data entry instead of actual decision-making.
We build claims automation pipelines that ingest ACORD forms, extract structured data with OCR and NLP, run business rules for coverage verification, and push straight-through processing for low-complexity claims. For a mid-market carrier, we cut average claims cycle time from 14 days to 3 by eliminating the manual handoffs between intake, coverage check, and payment authorization.
On the policy admin side, we replace brittle mainframe batch jobs with event-driven architectures that handle endorsements, renewals, and cancellations in real time. Rating engines run in sub-second response times instead of overnight batch queues.
// Capabilities
Claims Automation
End-to-end FNOL-to-payment pipelines. OCR extracts data from loss runs and ACORD forms, rules engines validate coverage, and straight-through processing handles low-severity claims without human intervention. Adjusters only touch the exceptions.
Policy Administration
Event-driven policy lifecycle management replacing batch-based legacy systems. Endorsements, renewals, cancellations, and reinstatements process in real time. Rating engines return quotes in under 200ms instead of queuing overnight.
Underwriting Workbenches
Consolidated underwriting dashboards that pull loss history, third-party data enrichment, and risk scoring into one screen. Submission triage models route risks to the right underwriter based on appetite rules and capacity.
Regulatory Compliance & Reporting
Automated state filing generation, surplus lines tax calculations, and NAIC annual statement data extraction. Audit trails track every policy transaction with immutable logs for DOI examinations.
// Frequently Asked
How long does insurance claims automation take to implement?
A typical claims automation project runs 12-16 weeks from kickoff to production for a single line of business. We start with the highest-volume, lowest-complexity claim type to prove ROI fast, then expand to additional coverages. Most carriers see 60-70% straight-through processing rates within the first quarter.
Can you integrate with existing policy admin systems like Guidewire or Duck Creek?
Yes. We build integration layers on top of existing PAS platforms rather than ripping them out. We connect via their published APIs or, for older systems, database-level integration with CDC (change data capture). The goal is incremental modernization, not a multi-year replatform.
What insurance compliance standards do you handle?
We build for NAIC reporting requirements, state-specific filing formats, surplus lines tax rules, and DOI examination readiness. Every policy transaction gets an immutable audit log. We also handle OFAC screening and sanctions checks as part of the underwriting workflow.
How does AI help with insurance underwriting?
We use document extraction models to pull structured data from submissions—loss runs, financials, supplemental apps—so underwriters don't re-key. Risk scoring models trained on historical loss data flag outliers. It's not replacing underwriters; it's eliminating the 3-4 hours of data gathering per submission.
// Related Work
Insurance & InsurTech
AI-Driven Health Insurance Claims Adjudication
Our AI claims adjudication platform auto-processes routine health insurance claims by validating ICD-10/CPT code combinations, applying medical necessity rules, checking member eligibility, and computing allowed amounts—reducing average adjudication time from 5-7 days to under 30 seconds for 75% of submitted claims. The remaining 25% are routed to human examiners with AI-generated decision support that highlights anomalies and suggests disposition. Clients reduce claims processing costs by 60% while simultaneously improving fraud detection rates by 3x compared to rules-only systems.
// Related Services
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