Agentic AI for insurance claims intake
How an AI agent could triage first notice of loss, check completeness and route claims — with adjusters in control.
The situation
A property & casualty insurer receives claims by email, web form and phone transcripts. Intake staff spend much of their day reading documents, re-keying data into the claims system, chasing missing information and routing cases. Backlogs grow after storms, delaying customers when they most need help.
Our approach
Map the intake workflow
Document every intake path, required fields, routing rules and exceptions with the claims team.
Build an intake agent
An agent reads each submission, extracts policy number, loss details and attachments, checks the policy in the core system and identifies missing information.
Human-in-the-loop routing
Complete, low-complexity claims are routed automatically; anything ambiguous, high-value or potentially fraudulent goes to an adjuster with a prepared summary.
Customer follow-up
The agent drafts requests for missing documents for staff approval before sending.
Guardrails & audit
Least-privilege access, full tracing of every decision and weekly quality review.
Typical technology
What success looks like
Metrics we would agree with you up front and track throughout:
- Time from first notice to assignment
- Share of claims needing re-keying
- Requests for missing information per claim
- Adjuster time per claim
- Customer satisfaction at intake
This is an illustrative scenario showing how Inspired Infotech approaches this type of problem. It does not describe a specific client, and actual approach and outcomes depend on each organisation’s systems, data and goals.
Services behind this scenario
Agentic AI
AI agents that plan, use tools and complete multi-step work — with humans in control.
Learn moreGenerative AI
LLM-powered assistants, RAG search and content automation — secure, grounded and enterprise-ready.
Learn moreMicrosoft Azure
Azure migration, app modernization, data platforms and Azure OpenAI for Microsoft-centric enterprises.
Learn moreFacing a similar challenge?
Let’s talk about your situation and what a realistic plan looks like.