Insurance Claims Processing Solution

The Insurance Claims Processing Solution enables insurers to modernize claims adjudication by automating document validation, policy alignment, fraud detection, and compliance checks across high volume automobile and property insurance workflows. Traditional claims operations depend heavily on manual reviews, fragmented documentation, and inconsistent rule interpretation, leading to delayed settlements, increased loss adjustment expenses, and heightened regulatory risk.

This AWS native solution delivers a governed, AI enabled claims workflow that standardizes decision logic and accelerates claim processing while preserving auditability. Claim documents are securely ingested and managed using Amazon S3, with structured and contextual data extracted through Amazon Textract and Amazon Comprehend. AI models deployed on Amazon Bedrock or Amazon SageMaker evaluate extracted information against underwriting rules, policy logic, and fraud indicators. Workflow execution is orchestrated using AWS Lambda and AWS Step Functions, while Amazon OpenSearch maintains traceable evaluation records to support audit and compliance requirements.

Security and governance are enforced through IAM based access controls, Amazon Cognito authentication, VPC isolation, and AWS KMS encryption. The solution integrates seamlessly with existing claims management platforms and core insurance systems, enabling scalable adoption without operational disruption.