Case study
AI in insurance case study: preparing motor and property claim files for a regional insurer
ResultClaim information, policy details and supporting documents were assembled for adjusters, who retain authority over coverage, reserves and settlement.
- Client
- A US regional insurer (anonymised)
- Industry
- Insurance (motor and property)
- Service
- Insurance claims automation: triage, coverage checks, reserve and settlement drafts, referral and deadlines
- Type
- Claim files prepared across the policy, claims, document and finance systems
- Status
- Delivered
We built claims automation for a regional insurer handling motor and property claims. The workflow prepares the file an adjuster needs by connecting claim records, policy information, supporting documents and payment history. Models handle document reading; the insurer's rules handle routing and deadlines. Adjusters make the claim decisions.
The starting point
Adjusters gathered information from a claims platform, a separate policy administration system, emailed estimates and photographs, and the finance system. Preparing that material left less time for careful assessment and communication with claimants. Authority limits, referral requirements and state-specific deadlines also needed to remain visible throughout the claim.
What we delivered
We connected the systems and added document extraction with uncertain fields flagged for confirmation. The workflow assembles the policy and claim context, applies assignment and authority rules, tracks deadlines and prepares draft materials for review. Writes to operational systems are performed through code and logged with their supporting evidence.
Rollout and handover
We introduced file preparation in stages and checked the extracted fields and routing against adjuster review. The insurer's authority table, referral indicators and deadlines were captured as explicit rules. Exceptions and draft communications remain in the review path rather than being released by a model.
Where people remain in control
The automation prepares information and drafts for review. Authorised staff decide coverage, liability, reserves, fraud referrals and settlement, and approve communications to claimants. An uncertain extracted field is flagged for confirmation.
Project outcome
The delivery brought claim preparation into a connected workflow with traceable source material and clear review responsibilities. Adjusters can work from the assembled file and confirm uncertain details. Coverage, liability, reserves, fraud referral, settlement and claimant communications remain decisions for authorised staff.
How performance is evaluated
| Measure | How it is measured | Comparison point |
|---|---|---|
| Time from a new claim to an assigned adjuster | Time stamps at the claim's creation and at assignment, by line | The same measure before automation |
| Adjuster time to assemble a file | Handling time logged before the first decision on each claim | The same measure before automation |
| Files accepted as prepared | Files an adjuster worked without changing the preparation, over all files, by line | The parallel run |
| What the adjusters change | Each change to a prepared coverage check, reserve rationale or settlement, with its reason | From the first week in parallel |
| Days from first notice to settlement | From first notice to the settlement being issued, by line and state | The same measure before automation |
| Deadlines missed | Acknowledgement and decision deadlines that passed without a letter, by state | The same measure before automation |
Technologies and tools
- The policy administration system's API, read only
- The claims system's API, for assignment, drafts, tasks and referrals
- A model reading estimates, reports, photographs and letters
- Rules in code: assignment, authority, referral and each state's deadlines
- Email and the document store, for filing documents and drafting letters
- The finance system, read only
- Vehicle, property and claims-history data, read only
- The insurer's own cloud account
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Bring us the claim preparation taking time from adjusters
Tell us which lines you write, where claims are handled today and how many arrive in a month. An engineer replies within two business days with which parts of each file could be prepared before an adjuster begins their review.