Home / Case studies / Claim review (example)
Scenario (example) · Finance and insurance
Claim review: an example scenario
This is a scenario, not a client result. It shows what a pilot at an insurance company could look like.
The problem (example)
For every claim, an adjuster checks the claim form, invoices and photos against the policy terms. The compliance check takes days, because the documents come in different formats and the clauses are looked up by hand.
How it would work
Documents
The claim form, invoices and policy are read automatically: PDF, photo or email.
Checking
AI checks amounts, dates and cover against the policy clauses.
Document
AI fills in the decision document with a quote from the policy for every finding; anything unclear goes “for review”.
Approval
The adjuster reviews and decides. AI never approves or rejects a claim.
The boundaries
- The claim decision stays with a person
- In the core systems, AI only reads and never writes
- Data stays in the EU
What we would measure
In the pilot we would measure: time to check one claim before and after; how many findings the adjuster corrects; how many claims go “for review”.
This is a scenario with no measured result. Our real case study is in FMCG and distribution.
How the pilot would run
4–6 weeks, one claim type
Week 1: analysis of the process and the decision document. Weeks 2–3: synthetic claims and the first documents. Weeks 4–6: real claims approved by an adjuster, corrections and measurement. Then you decide whether to scale.
Is this a real case study?
No. It is a scenario that shows how we work in finance and insurance. Our real case study is in FMCG / distribution.
Can we try it with our own data?
We start with a demo on synthetic data, then run a pilot with your data, under contract and NDA.
Next step
Show us one process that slows you down
In the demo you see a working solution on synthetic data instead of a slide deck. Then you decide whether to move on to analysis and a pilot.