The Impact
3
x
faster settlement for low-complexity claims
99
%
accuracy in data extraction
40
%
reduction in Loss Adjustment Expenses through automation
Enterprise AI: Build or Buy?
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The insurer’s multi-line claims operations - spanning health, auto, property, and specialty - were constrained by manual, document-heavy workflows. Provider invoices, medical records, repair bills, and police reports arrived as PDFs or scans, forcing handlers to manually rekey data into fragmented systems of record. This drove up loss adjustment expenses (LAE), extended cycle times, and created compliance risks, while limiting scalability during surge events.
Unframe deployed an AI-powered claims automation solution that digitizes and validates unstructured submissions, auto-updates systems of record, and applies AI-based fraud and compliance checks. Routine, low-complexity claims flow through straight-through processing (STP), while exceptions are flagged for adjuster review. The carrier achieved faster adjudication, reduced leakage, stronger regulatory compliance, and improved policyholder satisfaction across global lines of business.
FNOL Intake → Claim Abstraction → Liability Reconcile → Agents Adjudicate → Exception Escalation → Audit Trail
