Claims operations end to end
From notice to payment: voice intake, photo assessment, repair-shop assignment and subrogation in one flow.
Claims operations end to end is an Aginies solution package for the Insurance sector in the “operational automation” area. What the agents do: Notice taken by voice or app; the policy matched and the incident form completed in one conversation; parts and labour estimated from photos; fraud screening via prior-damage and metadata checks. Expected outcomes: simple claims close in days; adjuster capacity reserved for complex files; more subrogation, less leakage. The package uses the SIP voice, Vision damage assessment, Policy & claims tools (MCP), Human-in-the-loop capabilities of the Aginies platform and can be watched live through the End-to-end motor claim: from notice to payment, Voice claims intake (FNOL), Motor claim photo assessment, Subrogation recovery scenarios in the agent library.
A claim file travels across five teams and four systems; the customer calls at every step, adjusters visit simple files too, subrogation opportunities are missed.
- 01Notice taken by voice or app; the policy matched and the incident form completed in one conversation.
- 02Parts and labour estimated from photos; fraud screening via prior-damage and metadata checks.
- 03Cover, deductible and fault evaluated; a network repair shop assigned and the payment order prepared.
- 04Subrogation file opened automatically; above-threshold files land on the adjuster’s approval card.
- Notice by voice and app; policy matching and incident form
- Photo assessment, cover and fault evaluation
- Network repair-shop assignment, payment order and subrogation file
- Customer updates and file tracking; adjuster approval card
- API access to policy, claims and payment systems
- Repair network and parts price list
- Thresholds and adjuster rules per claim type
Derived from the linked scenarios: the supervisors, specialist agents, models and systems that run this package.
Summed from the simulation definitions of the linked scenarios; recalculated for your scale in the discovery session.
- Simple claims close in days
- Adjuster capacity reserved for complex files
- More subrogation, less leakage
| File closure time (simple claims) | From weeks to days |
| Files needing an adjuster | 40% fewer |
| Files with subrogation started | +25% |
Target ranges from comparable deployments; baseline and target are fixed together in the first week of the pilot.
Scenario-level approval rules plus the package’s general controls.
- 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
- Motor claim photo assessmentEstimate > 15,000 or model confidence < 80% → adjuster approval
- Subrogation recoveryRecovery demand > 50,000 → subrogation counsel approval
- packageAbove-threshold amounts, unclear fault and overlap with prior damage under adjuster approval
- packagePhoto metadata and decision reasoning on file; fraud check on every file
- 1 · Process map · 2 weeksSignal sources, decision points and work-order systems mapped; the automatic-decision boundary and approval chain defined.
- 2 · Pilot · 4 weeksOne line, one region or one process; the agent prepares the recommendation, a person applies it; deviation and gain measured.
- 3 · Autonomous operationDecisions below the threshold run automatically, above it go to approval; shift reports and SLA dashboards live.
This package’s scenarios in the agent library
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.
Voice claims intake (FNOL)
The customer calls and describes it; policy found by plate, cover checked, claim opened and adjuster assigned.
Motor claim photo assessment
Damage detected from photos, estimate built from parts and labour, adjuster only approves; repair slot booked.
Subrogation recovery
Closed claims scanned, the at-fault party's insurer identified, and the demand sent after counsel approval.
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.
- Your 2–3 priority problems
- Live demo of a similar scenario
- Roadmap starting with value analysis