Overview
Claims organizations continue to face increasing claim volumes, rising loss adjustment expenses, and growing customer expectations for faster, transparent claim resolution. Virtusa's Agentic Claims Solution applies AI-driven orchestration across the claims lifecycle to support adjusters, examiners, and supervisors with timely, contextual recommendations rather than isolated automation. Specialized AI Agents assist with policy coverage interpretation, document and image analysis, fraud indicators, repair estimate validation, reserve recommendations, and settlement preparation while routing complex exceptions for human review. The solution enables insurers to modernize claims operations while integrating with existing policy administration, claims, document management, and third-party vendor systems hosted on AWS.
Highlights
- Intelligent First Notice of Loss (FNOL) & Claim Intake: Automates the intake and validation of claim information from policyholders, brokers, images, documents, and third-party sources, enabling faster claim registration, improved data quality, and reduced manual effort at the start of the claims journey
- AI-Assisted Claims Assessment & Decision Support: Supports adjusters with intelligent policy coverage interpretation, damage assessment, liability analysis, fraud indicators, reserve recommendations, and settlement guidance, enabling more consistent and informed claim decisions while routing complex cases for human review
- End-to-End Claims Lifecycle Orchestration: Orchestrates the complete claims process from FNOL through investigation, estimation, approvals, settlement, and closure, improving operational efficiency, reducing claim cycle times, and providing greater visibility into claim status and exception management
Details
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