Workflow use case · 1
End-to-end claims processing agent
Intake → assessment → decision with full traceability — for claims operations and adjusters, aligned to our full claims demo.
You
Claimant reported water damage from a burst pipe on 03/15 — what are coverage highlights, deductible, and exclusions for policy POL-88421?
Coverage-oriented view from the policy packet and latest intake — consistent with intake → verification → decision:
- Coverage: Sudden pipe bursts under the water-damage endorsement; watch mold sublimits and flooring clauses per §4.2.
- Verification: Limits, deductibles, exclusions; cross-check prior claims and loss history.
- Next steps: Photo validation, field inspection if needed, reserve range, fraud score, and audit-ready documentation.
- Intake agents extract structured fields from email, web, PDFs, images, and voice across channels.
- Coverage verification and fraud detection score risk before routing to an adjuster.
- Decision outputs: explanation, reserves, next steps; communications draftable with cited policy language.
- Full audit trail for compliance; low-complexity claims can run straight-through.