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CASE STUDYINSURANCE

Claims decided in minutes on an owned brain

Pre-inspection, underwriting decisions and KYC running on their own intelligence layer — an insurance enterprise that stopped renting AI and started owning it.

INSURANCE · OWNED INTELLIGENCE LAYER

The challenge

Claims pre-inspection is a volume business with judgment at its core: thousands of daily cases, each needing policy checks, document verification, history lookups and a defensible decision. The incumbent process swivel-chaired between the claims core, the CRM and document stores — days per claim, with reasoning that lived in adjusters' heads and vanished at every handover.

Off-the-shelf AI tools had been piloted and abandoned: they couldn't see across systems, couldn't apply the insurer's own policies, and couldn't produce the audit trail a regulated business requires.

The approach

01

Connect — claims core, CRM, document store

Three sources connected with RBAC preserved; the brain answers each adjuster within their own permissions.

02

Structure — one graph of claims reality

Claimants, policies, vehicles, garages and history resolved into entities; the insurer's ontology defined and gated with their experts.

03

Reason — their policies, versioned

Eligibility and fraud-signal policies encoded as versioned artifacts; every decision ships with rationale.

04

Gate — named owners for exceptions

In-policy approvals flow straight through; exceptions route to named senior adjusters with full context.

05

Deliver — write-backs + operator dashboard

Decisions write back to the claims core; operations runs on a live queue-and-metrics console.

The results

9.76LClaims processed
77Weeks live
3Functions on one brain
1Named owner per exception

Why it worked

The metric that matters: claims that took days now close in minutes — at lakhs of cases of scale, without surrendering judgment on the cases that need it. Human attention concentrated on genuine exceptions; automation absorbed the volume.

And the asset stayed: the ontology, skills and policies are the client's own Company Brain, now powering underwriting decisions and KYC beyond the original scope. That's the difference between buying a project and owning a capability.

Your function could be next.

Every case here started as one scoped conversation about one painful workflow.