Not one generic AI, but specialized models optimized for specific tasks in the claims process.
Extracts facts from intake documents: who, what, where, when
Checks if all required documents are present
Auto-classifies claim type and coverage
Determines coverage with policy citations
Finds relevant policy conditions for the claim
Detects suspicious patterns without accusations
Assesses liability and recommends next action
Detects invoice anomalies and duplicates
Assesses payout risk for approval
Estimates settlement based on damage and policy
Drafts polite email requesting missing info
Generates document request with checklist
Drafts settlement proposal with explanation
Generates closure notice with thanks
Predicts SLA breach and recommends action
Detects customer sentiment for escalation