Automating Claims Processing for a Mid-Size P&C Carrier
End-to-end claims automation — from document intake and AI classification to intelligent routing and compliance logging — for a carrier processing 10,000+ claims monthly.
Mid-Market Property & Casualty Carrier
A regional property and casualty insurance carrier processing over 10,000 claims per month across personal and commercial lines. The claims team was drowning in manual document review, with a growing backlog threatening SLA compliance and customer satisfaction scores.
Manual review bottleneck threatening SLA compliance
Every claim required manual document classification, data entry, and routing. Adjusters spent more time on administrative tasks than on actual claim evaluation, leading to a 5-day average processing time that was pushing against regulatory SLA requirements.
Document classification errors led to misrouted claims, duplicate work, and compliance reporting gaps that required manual reconciliation at the end of each month.
5-day average processing time per claim
Manual document classification with high error rates
Adjusters spending 60% of time on administrative tasks
Monthly compliance reporting requiring manual reconciliation
Growing backlog threatening state SLA requirements
End-to-end claims automation pipeline
Intelligent Document Intake
Automated document ingestion system that accepts claims submissions via email, web portal, and API. The system handles PDFs, images, scanned documents, and structured forms — extracting text via OCR and normalizing data into a consistent format for downstream processing.
Key Capabilities
AI-Powered Document Classification
Machine learning models trained on historical claims data to automatically classify incoming documents by type — first notice of loss, medical records, repair estimates, police reports, and supporting evidence. The system routes each document to the appropriate workflow stage.
Key Capabilities
Data Extraction & Routing Engine
Structured data extraction from classified documents — pulling key fields like policy numbers, loss dates, damage descriptions, and claim amounts. The routing engine then assigns claims to the appropriate adjuster queue based on claim type, severity, and team capacity.
Key Capabilities
Compliance & Audit Logging
Every action in the claims pipeline is logged with full audit trails for regulatory compliance. The system tracks document lineage, classification decisions, routing logic, and adjuster actions — generating compliance reports for state insurance department audits.
Key Capabilities
Claims Analytics Dashboard
Real-time dashboard showing claims volume, processing times, classification accuracy, and adjuster productivity. Managers get visibility into bottlenecks and can track SLA compliance across the entire claims operation.
Key Capabilities
From 5-day processing to same-day resolution
80%
Reduction in manual review
95%
Classification accuracy
5,000+
Documents processed monthly
3 wk
Delivery timeline
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