How a regional insurer deployed AI-powered claims automation — increasing straight-through processing from 8% to 47% while cutting average settlement time by 65%.
47%
Straight-through processing
65%
Faster settlement
30K
Claims/month processed
$4.2M
Annual cost savings
THE CHALLENGE
The insurer processed 30,000 motor and property claims monthly across 45 branch offices. Claims arrived as a mix of paper forms, emailed PDFs, mobile photos, and portal submissions — all in different formats with varying quality. Every claim required manual data entry, document verification, policy lookup, coverage determination, and multi-level approval. Average settlement time was 18 business days. Straight-through processing (claims resolved without human intervention) was only 8%. Adjusters spent 60% of their time on administrative tasks rather than complex claim assessment. Customer satisfaction scores were declining, and the regulator was flagging processing delays.
THE SOLUTION
InfoTech Foundry deployed Ops Agent + DocFlow as an integrated claims platform: Phase 1 — Document Intelligence (4 weeks): DocFlow deployed to ingest claims from all channels — scanned paper, email attachments, mobile uploads, and portal submissions. Auto-classification into 12 claim types with 99.1% accuracy. Field extraction for claimant details, policy numbers, loss descriptions, and amounts. Cross-validation against policy database for coverage verification. Phase 2 — Workflow Automation (5 weeks): Ops Agent configured with 23 claim workflow variants based on claim type, amount, and risk score. Simple claims (< threshold amount, clear documentation, no red flags) routed for straight-through processing — auto-approved and settlement initiated. Complex claims routed to appropriate adjusters with pre-populated assessment forms and suggested reserve amounts. Phase 3 — Fraud Signals + Governance (4 weeks): Added fraud scoring layer — cross-referencing claim patterns, claimant history, repair shop networks, and timing anomalies. GuardRail ensures all AI decisions have audit trails. AuditTrail generates regulator-ready processing reports on demand. Every auto-approved claim includes a full decision rationale.
ARCHITECTURE
RESULTS
Straight-through processing increased from 8% to 47% — nearly half of all claims resolved without human intervention
Average settlement time reduced from 18 business days to 6.3 days — a 65% improvement
Document processing time dropped from 25 minutes per claim to 90 seconds with DocFlow extraction
Adjusters now spend 75% of time on complex assessment instead of 40% — dramatically improving decision quality
Fraud detection flagged $1.8M in suspicious claims in the first 6 months — 3× the previous manual detection rate
Regulator-ready processing reports generated in under 5 minutes — previously required 2 weeks of manual compilation
PROJECT DETAILS
TIMELINE
13 weeks from integration to full production
TEAM
5 InfoTech Foundry engineers + insurer's claims operations and IT teams
DEPLOYMENT
Hybrid — cloud processing with on-premise policy and customer data
PRODUCTS USED
Ops Agent + DocFlow
"The combination of DocFlow and Ops Agent transformed our operation. Claims that used to take three weeks now settle in days. And the fraud detection caught patterns our adjusters would never have seen — it's already paid for itself."
— VP Claims Operations, Regional Insurer