Insurance

From first notice of loss to recovery: processes with tracked steps and defined approval points.

Insurance volumes swing, documents are scattered and every decision must be explainable to the regulator. Aginies runs claims intake, renewals, underwriting document processing and subrogation on one orchestration layer; adjuster assignment and payment approval stay with people.

In short

In Insurance, Aginies offers 6 live agent scenarios and 3 solution packages: End-to-end motor claim: from notice to payment, Voice claims intake (FNOL), Policy renewal offer, Underwriting document extraction, Motor claim photo assessment, Subrogation recovery; solutions: Voice AI for claims intake, Claims operations end to end, Underwriting and renewal operations. The blockers on the way to production are Storm-day capacity, Document chaos, Unexplainable decisions, Missed recovery; on the compliance side 4 requirements (including Privacy-compliant processing with sensitive data masking) are part of the deployment.

Why it does not reach production
01

Storm-day capacity

Loss notices pile up at the call centre; waiting erodes satisfaction.

02

Document chaos

Underwriting and claim files arrive in every format; missing documents stall the process.

03

Unexplainable decisions

The model produced an output with no rationale; indefensible to regulator and customer.

04

Missed recovery

Third-party liability stays buried in files; recovery opportunities are lost.

Where to start: the first 90 days

Three starting points; each measurable in a short pilot on existing systems.

  1. 01
    agent scenarioEnd-to-end motor claim: from notice to payment →

    Motor claims are the highest-volume, most visible process; photo assessment frees adjuster capacity immediately.

  2. 02
    agent scenarioVoice claims intake (FNOL) →

    Call-centre notices taken without a representative; a short pilot on the existing SIP stack.

  3. 03
    solution packageUnderwriting and renewal operations →

    Renewal season comes with the calendar; automatic offers move the renewal rate measurably.

Scenarios

Agents you can watch live for this sector

InsuranceHITL

End-to-end motor claim: from notice to payment

Voice notice, photo assessment, repair-shop assignment and payment order in one flow; the adjuster steps in only above the threshold.

21,000 runs / month 91.2% success 5 agents
InsuranceHITL

Voice claims intake (FNOL)

The customer calls and describes it; policy found by plate, cover checked, claim opened and adjuster assigned.

34,000 runs / month 95.8% success 5 agents
InsuranceHITL

Policy renewal offer

Policies re-priced, sharp increases go to approval; customer accepts with one tap and the policy is issued.

22,000 runs / month 94.4% success 4 agents
InsuranceHITL

Underwriting document extraction

Medical reports and labs read and assessed against the manual; underwriters only see files above threshold.

4,800 runs / month 94.9% success 4 agents
InsuranceHITL

Motor claim photo assessment

Damage detected from photos, estimate built from parts and labour, adjuster only approves; repair slot booked.

15,500 runs / month 93.3% success 4 agents
InsuranceHITL

Subrogation recovery

Closed claims scanned, the at-fault party's insurer identified, and the demand sent after counsel approval.

3,400 runs / month 95.5% success 4 agents
Sector architecture

Derived from the 6 scenarios in the sector: supervisors, specialist agents, Hub model families and systems touched.

Supervisors
Claims SupervisorRenewal SupervisorUnderwriting SupervisorSubrogation Supervisor
Specialist agents
Intake AgentPhoto Assessment AgentAdjuster AgentCommunication AgentSpeech AgentPolicy AgentClaims Registration AgentPricing AgentOffer AgentIssuance AgentDocument AgentMedical Assessment AgentUnderwriting AgentVision AgentEstimate AgentRepair Routing AgentLiability Scan AgentEvidence AgentRecovery Agent
Models (Hub catalogue)
aginies-voice-tr-v3aginies-konrul-1aginies-tulpar-4aginies-sunkar-1aginies-talay-2
Systems touched
Call Centre SIPPolicy AdminClaims SystemRepair NetworkPayment HubGenesys SIPPolicy Admin SystemGuidewire ClaimCenterWhatsApp Business APIRating EngineEmail (Exchange)Underwriting WorkbenchDocument Store (S3)Vector StoreParts & Labour Catalogue (Audatex)Repair Network PortalInsurance Registry (SBM)
Channels
voiceappwhatsappbatchemailwebapi
Simulation volumes
100,700runs / month
94.1%success rate
7.8 smedian duration
$0.0042estimated cost / run

Summed from the simulation definitions of the sector scenarios; recalculated for your scale in the discovery session.

Compliance and sovereignty
  • Privacy-compliant processing with sensitive data masking
  • Mandatory human approval on payment and rejection decisions
  • A reasoned, timestamped trail for every claim decision
  • On-premise or in-country dedicated region options
Regulatory frame
  • Insurance regulator rules and insurance IT requirements: claim and policy decisions reasoned, time-stamped, open to audit
  • Special-category personal data: health and damage photos processed inside the perimeter, masking and access logging mandatory
  • Payment and rejection decisions always with the authorised adjuster or underwriter; the agent prepares the file
Security →

Guardrails, approval and the evidence ledger: the compatible product Thulpar ↗

Recommended deployment

Dedicated region in Türkiye or the sovereign shared deployment; vision models for damage photos and health data on in-country GPUs.

Approval rules

Human-approval thresholds of the sector scenarios.

  • End-to-end motor claim: from notice to paymentEstimate > 150,000, unclear fault share or overlap with prior damage → adjuster approval
  • Voice claims intake (FNOL)Injury or reserve > 250,000 → warm transfer to a claims specialist
  • Policy renewal offerPremium increase > 20% or discount > 10% → renewal team lead approval
  • Underwriting document extractionLoading ≥ 50% or sum assured > 5,000,000 → senior underwriter approval
  • Motor claim photo assessmentEstimate > 15,000 or model confidence < 80% → adjuster approval
  • Subrogation recoveryRecovery demand > 50,000 → subrogation counsel approval
Measured targets
Simple claim closure timeFrom weeks to days
Files needing an adjuster40% fewer
Policies renewed automatically60–75%

Target ranges from comparable deployments; baseline and target are fixed together in the first week of the pilot.

Related solution packages

Time to move from experimenting with AI to transforming with it.

In a 30-minute discovery session we take your 2–3 priority business problems, show a live demo of a similar scenario, and draft a roadmap that starts with the Value layer.

Book a 30-minute discovery session → dahi@aginies.com
  1. Your 2–3 priority problems
  2. Live demo of a similar scenario
  3. Roadmap starting with value analysis