Insurance Claims Automation
End-to-end claims processing automation — FNOL intake, document assessment, damage evaluation, and settlement recommendation using LLMs and computer vision.
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Insurance Claims Automation · Agent Mesh
FNOL Intake
Claim reported via phone, web, email, or mobile app.
Key Features
FNOL Automation
AI-powered first notice of loss intake with natural language processing and guided questions.
Document Assessment
LLM analysis of claim documents — police reports, medical records, repair estimates.
Damage Evaluation
Computer vision analysis of damage photos for automated assessment and cost estimation.
Settlement Recommendation
AI-generated settlement recommendations with policy coverage analysis.
Fraud Detection
Pattern-based fraud detection across claims history and submission patterns.
Customer Communication
Automated status updates and personalized communication throughout claims lifecycle.
How It Works
FNOL Intake
Claim reported via phone, web, email, or mobile app.
Document Collection
AI guides claimant through required documentation.
Damage Assessment
AI analyzes damage photos and repair estimates.
Policy Analysis
LLM analyzes policy coverage and applicable terms.
Fraud Screening
Automated fraud detection and investigation trigger.
Settlement Recommendation
AI generates settlement recommendation with justification.
Approval & Payment
Settlement approved and payment processed.
Closure & Feedback
Claim closed with customer satisfaction survey.
Multi-Agent Architecture
FNOL Agent
Handles first notice of loss intake with natural language processing.
- Claim intake
- Information extraction
- Guided questioning
- Priority assessment
- Route assignment
Assessment Agent
Analyzes claim documents and damage evidence for accurate evaluation.
- Document analysis
- Damage assessment
- Cost estimation
- Policy matching
- Coverage verification
Fraud Agent
Detects potentially fraudulent claims using pattern analysis.
- Pattern detection
- History analysis
- Inconsistency flagging
- Risk scoring
- Investigation support
Settlement Agent
Generates settlement recommendations based on policy and assessment.
- Settlement calculation
- Policy interpretation
- Negotiation support
- Approval routing
- Payment processing
Communication Agent
Manages claimant communications and status updates.
- Status updates
- Document requests
- Decision delivery
- Sentiment monitoring
- Escalation triggers
Use Cases
Auto Insurance Claims
Automate vehicle damage assessment and claims processing.
Property Claims
Process property damage claims with photo analysis and cost estimation.
Health Claims
Automate health insurance claims processing and adjudication.
Travel Claims
Process travel insurance claims with document verification.
Liability Claims
Assess liability claims with evidence analysis and policy review.
Workers' Comp
Automate workers' compensation claims intake and processing.