P&C Claims Intake and Triage Automated: FNOL to Adjuster Queue in Under 30 Minutes

// the problem

Claims arrive via email and form submissions but require 2–5 days of manual triage. Skilled adjusters waste time extracting claimant data, checking policy coverage, assigning severity, and routing to the correct queue — a purely administrative task that delays SLA compliance and inflates costs. Approximately 40% of claims miss the 30-minute SLA target. SLA breaches incur penalties. The irony: the most expensive people in the operation are doing the most mechanical work.

// what CLU does

A five-agent swarm orchestrates the entire claims intake lifecycle autonomously. Every step — from data extraction to policy verification, severity assignment, routing, acknowledgment, and compliance logging — runs without human intervention. CLU never decides coverage unilaterally: policy gaps automatically escalate to a senior adjuster. 98% of claims are routed in under 30 minutes with zero hallucinations.

// the agents, in order

1. 1
   NLP Parsing Engine

   Extracts claimant name, policy number, date of loss, loss type, and contact info from emails and forms in real time — zero manual data entry
2. 2
   Policy Verification Agent

   Queries Policy Admin API to verify active coverage — gaps are immediately flagged and routed to senior adjuster, CLU never decides coverage unilaterally
3. 3
   Severity & Routing Agent

   Assigns CAT or non-CAT severity, routes to correct adjuster queue by loss type and geography, creates claim record automatically in Claims System
4. 4
   Acknowledgment Agent

   Sends claimant acknowledgment within 15 minutes — episodic memory flags recurring claim patterns at specific policy types for proactive risk alerts
5. 5
   Compliance Audit Agent

   Logs every action in immutable Compliance Audit DB with full JSONB timestamped event trail — every decision documented and ready for regulatory review

// systems it talks to

• Email / Form
• NLP Parsing Engine
• Policy Admin API
• Claims System API
• Adjuster Queue
• Slack Alert
• Compliance Audit DB

// more cases in P&C Insurance

• Policy Renewal Retention Automated 90 Days Out: Stop Losing 15–25% of the BookCarriers stop losing 15–25% of their book to reactive outreach. Every retention touchpoint runs on schedule, 90 days out, with no manual reporting.
• P&C Claims Vendor Coordination Automated: Inspectors, Adjusters and Contractors in 6 Days Instead of 18Complete third-party vendor lifecycle orchestrated autonomously — from assignment to invoice approval. Vendor cycle compressed from 18 days to 6 days with zero email/phone relay.
• Florida P&C Claims Deadline Compliance: 14/30/90-Day Statutory Tracking Without Blind SpotsEvery open claim is a ticking compliance clock. CLU intercepts before breach — autonomously monitoring every claim against Florida's 14/30/90-day statutory deadlines with zero blind spots.
• Liability Underwriting Submissions Automated: Broker Emails to Quote 70% Faster9-agent swarm orchestrates every submission from data-sludge intake to broker-ready quote — 100% appetite consistency, 80% less operational effort.
• Third-Party Contract Risk Review with DORA and GDPR Compliance Checks at Ingestion6-agent swarm extracts risk from PDFs, auto-flags DORA gaps, redlines against Golden Standard, and models financial exposure — contracts are no longer static storage.
• TPD Disability Claims Screening Automated: Medical, Policy and Financial Logic in One PassMedical + policy logic resolved in parallel. 4-layer complexity (Medical · Legal · Financial · Human) processed in one pass with proactive reserve intelligence.
• Travel Insurance Claims Straight-Through Processing: Auto-Settlement in Hours, Not DaysNeural Grid STP resolves multi-format claims (PDFs, images, multi-currency) with >95% confidence auto-settlement — customers never repeat information.
• Motor Claims Lifecycle Automated from FNOL to Subrogation, with 30–40% Less FraudBefore · During · After — Risk DNA profiling, autonomous FNOL decisioning, subrogation recovery, and lifecycle intelligence orchestrated as one continuous loop.
• Health Insurance Policy Retention: Churn Signals Detected Before the Renewal Window Opens6-agent Smart Policy Engine compares plans dynamically, personalizes offers by usage and churn risk, and engages customers conversationally — before they stop renewing.
• Kinesiology Claims Fraud Detection: False Licenses, Session Inflation and Rings Caught Before PaymentCLU + Aictive: Gatekeeper, Enforcer, and Watchdog layers detect false licenses, session inflation, and organized rings — pre-payment, not post-investigation.