Faster claim cycles

Faster claim cycles

Claims that drag past three weeks hurt CSAT and retention. Classify documents, extract data, route work, and automate routine steps with agentic automation — from FNOL through coverage checks to payment. Cut cycle times and handoffs while keeping complete appeal trails.

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Scale without hiring

Scale without hiring

Avoid hitting capacity limits, whether from talent scarcity or catastrophe-driven claims spikes. Intelligently automate submission ingestion, clearance checks, and routine work with role-based controls to handle CAT surges, maintain SLAs, and scale underwriting and service without adding headcount.

Maximize recovery and eliminate indemnity leakage

Maximize recovery and eliminate indemnity leakage

Improve recovery rates, reduce fraud losses, and support audit requirements with AI agents that surface subrogation opportunities, validate indemnity and payments, trigger SIU referrals from emerging patterns, and document every decision.

Where agentic automation works in insurance

  • Claims Management
  • Underwriting & New Business
  • Policyholder & Contact Center
  • Fraud, SIU, & Recovery
  • Agency, Broker, & Distrib. Ops
  • Finance, Data, and Compliance

Claims Management

Why do claims take so long? Manual document handling, routing delays, and fragmented data. Automate intake through payment with agentic process automation (APA) to cut cycle times and improve satisfaction.

  • Doc triage & extraction
  • Fraud detection
  • Adjuster assign and route
  • Coverage/limits checks
  • Claim review and approval
  • Identify subrogation

Underwriting & New Business

AI agents turn days of submission work into hours. Deploy agentic automation to ingest broker packs, run appetite checks, source MVR and MIB data, and complete checklists to speed quotes and grow capacity.

  • Broker pack ingestion
  • External data sourcing
  • Medical record review
  • Risk/fraud assessment & detection
  • Pre-bind checklist
  • Renewal summarization

Policyholder & Contact Center

Contact centers are drowning in routine requests that AI can handle. Automate address changes, policy updates, and claim status inquiries, freeing reps for complex service issues.

  • Proof-of-insurance requests
  • Payment plans and refunds
  • Policy issuance & updates
  • Claim status deflection
  • Cancellation and renewal
  • Surrenders and lapses

Fraud, SIU, & Recovery

AI agents catch what manual reviews miss. Apply agentic automation to flag intake anomalies, run KYC checks, trigger SIU referrals when patterns emerge, and prepare recovery packets to reduce fraud losses.

  • Anomaly flags at intake
  • Identity/KYC cross-checks
  • SIU referral packaging
  • Interview/recording summ.
  • Recovery packet assembly

Agency, Broker, & Distrib. Ops

Agentic automation takes care of licensing, commission calculations, bordereaux processing, and performance reports. Less administrative burden clears time for teams to focus on distribution strategy.

  • Producer onboard & license
  • Commission calculations
  • Bordereaux ingestion
  • Performance reporting

Finance, Data, and Compliance

Compress weeks spent on reconciliations and regulatory prep into days. Process invoices, execute GL reconciliations, and prepare submissions with agentic automation to shrink close cycles and meet deadlines.

  • AP invoice processing
  • ESG reporting
  • Regulatory submissions
  • Data validation & lineage
  • Data migration (ACORD)

Proven results for insurers

EXL
EXL
  • 60% decrease in processing time
  • 80% reduction in audits
  • 100% accuracy

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Frequently asked questions

What makes agentic automation for insurance different from traditional claims automation?

Agentic automation for insurance orchestrates work across systems, documents, and people rather than relying on fixed scripts. Automation adapts to different claim and policy scenarios, routes work based on complexity and urgency, and coordinates fraud detection, subrogation, and human review across the end-to-end process instead of handling tasks in isolation.

What level of human oversight does agentic automation for insurance require?

Agentic automation for insurance uses human-in-the-loop controls to balance scale with oversight. Routine work is handled automatically, while high-value claims, policy exceptions, and edge cases are routed to underwriters or adjusters with full context. Teams define thresholds and routing rules so automation scales volume without removing human judgment.

Can agentic automation for insurance reduce fraud and leakage?

Agentic automation for insurance reduces fraud and leakage by validating calculations, flagging anomalies early, and surfacing subrogation opportunities during processing. Automated workflows trigger SIU referrals when risk indicators appear and prepare investigation materials with supporting evidence, improving recovery rates and audit outcomes.

What data security controls does agentic automation for insurance provide for sensitive policyholder information?

Agentic automation for insurance protects policyholder data using role-based access controls, PII and PHI masking, encryption, and time-stamped audit logs. All data access is recorded with user attribution, supporting regulatory requirements for handling medical, financial, and customer information across automated insurance operations.

How can agentic solutions work for you?

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