AI claims agents for P&C and auto carriers — from FNOL to drafted settlement.
Carriers burn 10 to 15 cents of every claim dollar on adjudication — most of it routine document reading. We build a production agent that reads the first notice of loss, verifies coverage, and drafts the settlement for your team to approve.
What the agent actually does.
A production agent that reads a claim and drafts the settlement — with adjusters on the exceptions.
How the agent runs
First notice of loss to a payment-ready package, every step eval-gated.
Proven, not promised
Benchmarked against adjuster decisions before it touches a live claim.
eval pass rate on routine claims
Reads every source
Forms, images, and reports — structured and unstructured.
Structures the data
Extracts the facts of loss and structures them for the adjuster.
Decides with evidence
A documented recommendation the adjuster approves.
Adjudication is a tax on every claim you pay.
Loss-adjustment expense runs 10 to 15 cents on the dollar, and most of it goes to reading documents, not making decisions. The agent takes that routine review off your adjusters and drafts the settlement for approval.
Routine claims clear themselves, adjusters handle the judgment.
Adjusters spend their day reading FNOLs and re-keying coverage details before they ever make a decision. The agent absorbs that work. Routine claims flow straight through to a drafted settlement, and your people handle negotiation, edge cases, and the contested claims where judgment pays off.
- Adjusters handle exceptions and judgment calls, not data entry
- Straight-through processing for routine claims, faster cycle times
- Consistent reserving and documentation across every adjuster
- Full audit trail and evaluation framework for regulators
A few points off the $0.10–$0.15 adjudication cost per claim dollar is worth millions a year. Faster settlements lift policyholder retention, too.
Common questions, answered.
What claims can an AI agent process?
Routine, high-volume P&C and auto claims — where the FNOL, photos, estimates, and reports follow predictable patterns. The agent reads them, verifies coverage, and drafts a settlement for adjuster approval; complex or contested claims are routed to humans.
Does AI claims automation replace adjusters?
No. It removes the document-reading and data-entry burden so adjusters focus on judgment, negotiation, and exceptions. Straight-through processing handles the routine volume that clogs queues.
How much can carriers save?
Carriers spend $0.10–$0.15 of every claim dollar on adjudication. Automating routine review meaningfully reduces that loss-adjustment expense while speeding cycle times and improving consistency.
Is it compliant and auditable?
Every decision is documented and cited, with an evaluation framework and human-in-the-loop controls from day one — designed for regulatory scrutiny and fair-claims requirements.
Go deeper: AI Claims Processing: How P&C Carriers Cut Adjudication Costs
Where adjudication cost hides, how an agent runs FNOL to settlement, and what to expect from a production deployment.
Ask about the 2-week auditTell us if AI claims processing is worth owning.
In a two-week audit we map your claim volume, the loss-adjustment expense you're carrying, and exactly where an agent pays for itself. You get back a build plan, not a pitch.