modern insurance command center with AI agents dashboard, multiple screens showing analytics, blue and orange ambient lighting, futuristic office environment
Complete Agent Portfolio

8 Strategic AI Agents for Complete Insurance Operations

From underwriting to compliance, deploy specialized AI agents that work together to transform your entire insurance operation.

75%
Faster Processing
95%
Accuracy Rate
60%
Cost Reduction
24/7
Operations

Complete AI Agent Portfolio

Eight specialized agents covering every aspect of insurance operations from policy inception to regulatory compliance.

Underwriting Risk Agent

Policy Application Processing

CORE AGENT

Automates evaluation of insurance applications by assigning risk scores based on historical claims, applicant behavior, and underwriting logic.

Key Functions

  • Risk score assignment
  • Historical claims analysis
  • Automated pricing rules
  • Outcome simulation

Key Metrics

Processing Speed 75% Faster
Risk Accuracy 94% Accurate
Manual Intervention 15% Reduction
Example: A 52-year-old applicant with recent hospitalizations applies for health policy. Agent reviews past claims, flags chronic illness patterns, and assigns higher risk score for pricing adjustment.

Claims Intake Agent

Document Processing & OCR

AUTOMATION

Automates extraction, classification, and structuring of data from incoming claim documents to feed into downstream adjudication systems.

Capabilities

  • OCR document scanning
  • Document classification
  • Data field extraction
  • Format standardization

Performance

Extraction Accuracy 95% Rate
Processing Time 80% Faster
Auto-Preparation 90% Claims
Example: Hospital uploads handwritten discharge notes and lab results. Agent reads, classifies, and populates claim form automatically for adjudication.

Preauthorization Agent

Real-time Authorization Decisions

REAL-TIME

Evaluates real-time preauth requests using policy rules, benefit tables, medical necessity criteria, and historical authorization behavior.

Operations

  • Policy coverage matching
  • Medical necessity validation
  • Historical pattern analysis
  • Instant decision delivery

Impact

Response Time Instant
Manual Overrides 12% Rate
Provider Satisfaction 92% Rating
Example: Hospital submits preauth for cataract surgery. Agent instantly approves based on historical preauths, age profile, and benefit validation.

FWA Detection Agent

Fraud, Waste & Abuse Prevention

SECURITY

Identifies potentially fraudulent, wasteful, or abusive claims using behavioral analytics, anomaly detection, and social network graph analysis.

Detection Methods

  • Anomaly pattern detection
  • Social network analysis
  • Risk index scoring
  • Provider linkage mapping

Results

Detection Rate 85% Higher
False Positives 25% Lower
Cost Savings ₹2.5M/Month
Example: Physiotherapy center consistently bills high-value services for short visits. Agent detects anomaly and links to similar cases across regions.

Payability Scoring Agent

Payment Legitimacy Validation

FINANCIAL

Predicts legitimacy and expected payout value of claims by comparing against historical norms, provider behavior, and policy parameters.

Analysis Features