AI-Powered Claims Automation
From first notice of loss to final settlement — automate every step of the claims lifecycle, reduce cycle times, and deliver faster, fairer outcomes for policyholders.
Claims lifecycle — live
FNOL intake
Received · auto-acknowledged
Document extraction
12 fields extracted · validated
Fraud & coverage check
Low risk · within policy limits
Adjuster assignment
In progress · AI-triaged
Settlement & closure
Awaiting adjuster decision
70%
Faster claim cycle time
4×
More claims per adjuster
95%
Straight-through processing
0
Manual FNOL entries
The challenge
Claims is where costs and complaints compound fastest
Slow, manual claims processes drive up loss adjustment expenses, frustrate policyholders, and expose insurers to fraud and leakage.
Slow FNOL & triage
First notice of loss handled manually through email and phone — causing delays from the very first moment a claim is filed.
Document-heavy processing
Adjusters spend hours extracting data from police reports, medical records, repair estimates, and photos — instead of making decisions.
Fraud leakage & overpayment
Without automated fraud signals and coverage validation, inflated or ineligible claims slip through — increasing loss ratios silently.
Poor claimant communication
Policyholders left in the dark about claim status — leading to call centre overload, complaints, and churn at renewal.
How it works
From FNOL
to closure — automated
PolisiQ's claims AI agents handle intake, extraction, triage, and communication — so adjusters focus on decisions, not data entry.
01
FNOL intake & acknowledgement
PolisiQ captures first notice of loss from any channel — email, portal, phone transcription, or API — and instantly creates a structured claim record with automatic acknowledgement sent to the claimant.
02
Document extraction & validation
AI reads and extracts data from all claim documents — police reports, medical records, invoices, repair estimates, photos, and correspondence — then validates coverage against the active policy.
03
Fraud signals & risk scoring
Automated fraud indicators are scored at intake — duplicate claims, inconsistent dates, known fraud patterns, and anomalous reserve amounts — flagging high-risk claims for specialist review before any payment decision.
04
Triage & adjuster assignment
Claims are automatically triaged by complexity, value, and line of business — routed to the right adjuster or straight-through-processed for simple, low-value claims without human touch.
05
Claimant communication & closure
PolisiQ sends automated, personalised updates to claimants at every stage — request for information, decision notification, payment confirmation — keeping them informed without burdening your team.
Platform capabilities
Built for the full claims
lifecycle — not just intake
PolisiQ goes beyond simple FNOL automation — it orchestrates the entire claims workflow from first contact to settlement.
FNOL capture & intake
Captures claims from email, web portal, API, or phone transcript — creating structured records instantly with no manual re-keying.
Document AI extraction
Reads and structures data from police reports, medical records, invoices, repair quotes, and images — ready for adjuster review in seconds.
Coverage & policy validation
Automatically matches the claim against the active policy — verifying coverage, deductibles, exclusions, and limits before any payment is considered.
Fraud detection & flagging
Scores every claim for fraud indicators at intake — duplicate detection, anomaly signals, and known fraud patterns — routing suspicious cases for specialist review.
Automated claimant comms
Sends structured, professional updates to claimants at every stage — acknowledgement, information requests, decisions, and payment notices — with full tracking.
Analytics & leakage control
Full dashboards on claim volumes, cycle times, STP rates, fraud flags, and reserve accuracy — with every decision logged for compliance and re-audit.
70%
Faster average claim cycle time
4×
More claims handled per adjuster
95%
Straight-through processing on simple claims
40%
Reduction in loss adjustment expenses
Powered by PolisiQ
Built for claims teams.
Delivered by CloudTern.
PolisiQ is CloudTern's dedicated AI platform for insurance workflow automation. The claims module brings together document AI, fraud signals, automated communications, and configurable triage rules into one easy-to-deploy solution.
- Deploy in weeks — no rip-and-replace of existing systems
- Configurable triage rules per line of business and claim type
- Integrates with your claims management system via API
- Claimant-facing communication fully automated and tracked
- Full audit trail for compliance, re-audit, and dispute resolution
- Backed by CloudTern's insurance domain and AI expertise
Overview
Documents
Timeline
Claim ID
CLM-2024-04821
Claimant
Sarah M. Thornton
Claim type
Auto — Collision
Date of loss
14 Apr 2024
Reserve amount
$12,400
FNOL intake
Auto-captured
Coverage check
In policy
Documents
4 of 4 extracted
Claimant notified
Sent
Use cases
Who benefits from
PolisiQ claims automation
01
Personal lines carriers
Handle high volumes of auto, home, and travel claims with straight-through processing for simple cases — freeing adjusters for complex or high-value claims that need human judgment.
02
Commercial lines insurers
Manage document-heavy commercial claims more efficiently. AI structures data from lengthy loss adjusting reports, contractor invoices, and legal correspondence so adjusters start informed.
03
Third-party administrators (TPAs)
Scale claims handling capacity without adding headcount. PolisiQ's configurable rules engine adapts to each carrier's appetite, coverage terms, and SLA requirements across your book.
04
Specialty & liability lines
Automate the administrative burden of complex liability, professional indemnity, and D&O claims — structured document extraction lets adjusters and lawyers focus on coverage analysis.
Ready to transform
your claims operation?
See PolisiQ claims automation in action. Our team will walk you through a live demo tailored to your line of business and claim volumes.
Request a demo Or explore PolisiQ.ai independently →
