Insurance Claims Processing leveraging Camunda and Agentic AI

Overview: Insurance customers expect speed, accuracy, and clarity when filing claims. HCLTech’s solution leverages AI and Camunda’s orchestration to automate document verification, real-time data analysis, and anomaly detection. This creates a seamless, adaptive, and customer-first claims experience.

• Industry Challenges Addressed:

o Slow, manual workflows and high error rates o Limited fraud visibility o Rigid legacy systems and resource inefficiencies o Low customer confidence due to lack of proactive communication o Key Solution Features: o Easy claim initiation via app, website, or phone, guided by AI-powered chat and voice agents o Intelligent document handling and data extraction o AI-powered claim assessment, fraud detection, and auto-approval of simple cases o Integration with legacy systems using RPA bots o Intelligent task assignment for adjusters o Continuous customer updates and seamless external collaboration o Personalized human support for complex claims o Continuous optimization through analytics

• Differentiators:

o Real-time, autonomous decisions using agentic AI o Operational excellence with intelligent case management o Superior customer experience with speed and transparency o Stronger fraud protection through continuous learning systems

HCLTech combines its insurance domain expertise with the power of Camunda and AWS to define, design, develop and help deliver a streamlined, AI-driven claims automation solution. By orchestrating workflows through Camunda and leveraging AWS services like Amazon Bedrock and AWS OpenSearch, the solution enables end-to-end automation—from claim initiation to resolution with real-time fraud detection, intelligent document processing, and scalable, secure operations.