Our processing framework reviews insurance claims to identify any information gaps applicable to the claim, and if relevant, the framework’s virtual agent will engage a client directly to ask for clarification regarding missing or unclear information
It reviews claims and any supplementary information for likelihood of fraudulence – for example checking that photographs have not been sourced from internet search engines. It then uses the rules specified within the framework to assess the claim’s validity and makes a decision accordingly.
The virtual agent can either supply a claim handler with a recommendation and rationale, or contact the client directly to notify them as to whether the claim is being accepted, and what their next steps are. The end-to-end processing of an insurance claim can be completed in seconds via the framework.