Insurance

Insurance claims automation built for the volume and scrutiny of real claims handling.

Claims processing generates a constant stream of document-heavy, deadline-driven work — intake triage, fraud screening, reserve estimation, settlement calculation, and subrogation recovery, each with its own compliance and audit requirements. Automata builds insurance claims automation that handles this volume reliably, with the audit trails and human sign-off gates that claims handling requires.

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Automating Claims Intake and Triage

One of the automations Insurance teams ask us for most, step by step.

  1. Starts when 1

    Claim submitted

  2. A Automata 2

    Classify severity and complexity

  3. Your systems 3

    Check documentation completeness

  4. Result 4

    Request missing information

  5. A Automata 5

    Route to queue

  6. Result 6

    Present to adjuster

See how it works, from €299 →

How Insurance organisations use Automata

Claims Intake & Triage

AI classifies incoming claims as first-party or third-party, routes to the correct handler, and flags missing documentation before a claim sits idle in a queue.

Faster first-touch on every new claim

Fraud Detection & SIU Routing

Pattern-based fraud flags on claims and the routing logic that sends genuinely suspicious cases to the Special Investigation Unit, so analyst time goes to the cases that actually warrant it.

Earlier fraud detection, fewer false escalations

Settlement Calculation & Payout

Settlement amounts calculated against policy terms and claim specifics, with a sign-off gate before payout release on anything outside standard parameters.

Consistent settlement math, faster payout on standard claims

Reserve & Reinsurance Support

Reserve adequacy reviews and reinsurance recovery calculations kept current against actuarial inputs instead of running on last quarter's assumptions.

Reserves that track real claims development

Policy Administration

Endorsement recalculations, non-renewal notice compliance tracking, and document version control across renewal cycles, so policy records stay accurate without manual chasing.

Fewer policy administration errors at renewal

Subrogation & Recovery

Automatic identification of subrogation opportunities and third-party liability recovery tracking, so recoverable costs don't get missed once a claim closes.

More recoverable costs actually recovered

Built for your regulatory environment

Every automation system we build for Insurance organisations includes the compliance architecture that regulated environments demand — full audit trails, human oversight checkpoints, and data handling that meets GDPR and sector-specific requirements.

MFSA insurance rules, claims handling conduct standards, GDPR for claimant data, anti-fraud reporting obligations.

Full audit trail on every automated decision
Human-in-the-loop checkpoints for consequential actions
GDPR-compliant data processing with EU data residency
Sector-specific regulatory expertise built in

Automations for Insurance

21 ready-to-deploy automations for jobs that come up again and again in insurance.

Actuarial Data Quality Checks Screen claims and exposure data for quality issues before pricing and reserving runs, so bad inputs don't quietly bias the output. Insurance Claims Processing From €299 Address and Geocoding Data Standardization Standardize inconsistent address formats and validate geocoding accuracy across your systems, so shipping, billing, and territory data actually agree. Data Entry & Migration From €99 Agent and Broker License Verification Tracking Automate ongoing verification of agent and broker license status across states, catching lapses before unlicensed business is written. Insurance Claims Processing From €299 Cancellation and Non-Renewal Notice Compliance Tracking Automate compliance tracking for policy cancellation and non-renewal notice periods and required content by state. Insurance Claims Processing From €299 Catastrophe Loss Reserve Estimation Support Automate early catastrophe loss reserve estimation from exposure and event data, before individual claim-level detail is available. Insurance Claims Processing From €799 Claims Closure Quality Audit Sampling Automate risk-weighted sampling of closed claims for quality audit, catching patterns a random or convenience sample would miss. Insurance Claims Processing From €299 Claims Correspondence Tracking Automate claims correspondence logging across email, phone and portal, so every adjuster sees the full communication history in one place. Insurance Claims Processing From €299 Claims Reserve Adequacy Review Flag under- and over-reserved claim files by comparing case reserves to comparable claim outcomes, routed to adjusters for review. Insurance Claims Processing From €799 Claims Vendor Network Assignment Automate claims vendor assignment — repair shops, appraisers, contractors — by capacity, performance and proximity, not a static rotation. Insurance Claims Processing From €299 First-Party vs Third-Party Claim Classification Automate first-party versus third-party claim classification at intake, so coverage and liability handling starts on the right track. Insurance Claims Processing From €299 Group Benefits Enrollment Reconciliation Automate reconciliation of group benefits enrollment data between employer HRIS feeds and the carrier's system of record. Insurance Claims Processing From €299 Identify Subrogation Opportunities Flag claims with real subrogation potential from liability signals in the claim file, before the recovery window narrows. Insurance Claims Processing From €299 Policy Document Version Control Across Renewals Automate policy document version tracking across renewals and endorsements, so claims are assessed against the correct wording. Insurance Claims Processing From €299 Premium Audit Scheduling and Documentation Automate premium audit scheduling and documentation collection so audits happen on time and adjustments are backed by complete records. Insurance Claims Processing From €299 Recalculating Premium After Mid-Term Endorsements Automate mid-term endorsement premium recalculation with pro-rata adjustment, before a wrong figure reaches the policyholder's bill. Insurance Claims Processing From €299 Reinsurance Recovery Calculation Automate reinsurance recovery calculation against treaty terms, layers and retention, with every recovery figure routed for sign-off. Insurance Claims Processing From €799 Reinsurance Treaty Compliance Tracking Track cession reporting and treaty limits automatically, flagging breaches before they surface in a reinsurer audit. Insurance Claims Processing From €799 Route Insurance Fraud Cases to SIU Automate routing of flagged fraud cases to the right special investigations unit investigator, with evidence packaged for case intake. Insurance Claims Processing From €299 Salvage Recovery Processing Automate total-loss salvage titling, vendor routing and bid tracking so recovered value doesn't erode while a unit sits idle. Insurance Claims Processing From €299 Third-Party Liability Recovery Tracking Track subrogation and liability recovery files from demand letter through settlement, so pursued claims don't go stale unmonitored. Insurance Claims Processing From €299 Underwriting Referral Routing for Out-of-Appetite Risks Automate detection and routing of out-of-appetite submissions to the correct senior underwriter, instead of a slow generic referral queue. Insurance Claims Processing From €299
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