AI-Driven Claims Processing & Adjudication
End-to-end intelligent claims automation that settles faster and costs less.
The Challenge
Claims are the moment of truth in insurance — and the most expensive. Manual adjudication introduces delays (average 14-21 days for simple claims), inconsistency across adjusters, and vulnerability to fraud. Policyholders increasingly expect fast, transparent, digital-first claims experiences. Insurers face mounting pressure to reduce loss adjustment expenses (LAE) while improving Net Promoter Scores.
The Quapt Agentic AI Solution
QUAPT designs and deploys a fully agentic claims processing pipeline. From the moment a First Notice of Loss (FNOL) is filed — via app, web, or voice — AI agents take over: extracting structured data from unstructured documents and images, matching coverage against policy terms, scoring for fraud indicators, and autonomously adjudicating straightforward claims within minutes. Complex or high-value claims are escalated to human adjusters with a complete AI-prepared dossier — dramatically reducing their review time.
Key AI Capabilities
- Intelligent FNOL intake via web, app, and voice channels
- Computer vision damage assessment for auto, property, and casualty claims
- AI document extraction from medical records, police reports, repair estimates
- Automated policy-to-claim coverage matching and exclusion checking
- Multi-signal fraud detection integrated into claims workflow
- Straight-through processing for low-complexity, low-value claims
- Human adjuster workbench with AI-prepared claim summary and recommendation
78%
Claims Auto-Adjudicated
14 days → 2hrs
Settlement Time Reduction
35%
Reduction in LAE
90%
Customer Satisfaction Score
Business Outcomes
- Dramatically faster claim settlements — improving policyholder experience and loyalty
- Significant reduction in Loss Adjustment Expense (LAE) across the claims portfolio
- More consistent adjudication decisions reducing regulatory and legal exposure
- Reduced fraud leakage through integrated, real-time fraud intelligence
- Human adjusters redeployed to complex, high-value claims where judgment matters
- Competitive differentiation through superior digital claims experience
