Claims Assistant
Adjusters ask any handling question and get an answer from your manuals, rules and the file, with its source.
Why it matters
Handling rules live in manuals, bulletins and fifty sets of state regulations; adjusters search or wait for a supervisor, and answers differ from desk to desk.
How the solution handles it
Four agents read the question, search your manuals, state rules and circulars, read the claim file in front of the adjuster and answer with every point cited. The adjuster decides what to do; questions and answers are logged for training.
How a question moves
Four agents read the question, search your manuals, rules and the file, and answer with sources; the adjuster decides what to do.
What it reads, and what it hands back.
What goes in
- Claims manuals and best practices
- State rules and bulletins
- IRDAI circulars
- The claim file
What comes out
- Cited answer
- Next-step checklist
- Note to file
- Questions log for training
Who uses it
The difference, in numbers.
Every figure is labelled: a target the solution is built to, an estimate, a typical published result, or a proven one.
“Target” = design goal, measured in the live solution · agents = the live solution’s configuration
4 specialist agents. One person decides.
More in this division.
Every first notice of loss read, scored and routed to the right adjuster within the hour.
Coverage LettersEvery coverage question answered from the policy wording, with a cited letter drafted for counsel.
Reserve ReviewEvery open claim’s reserve tested against its file each quarter, with gaps explained before anyone asks.
Build this
for your team.
We’ll show Claims Assistant running on your own documents.