Adjusters were overwhelmed. 70% of claims were simple—lost luggage, cracked windshields, minor water damage—but still required manual intake, routing, and approval. Resolution times were climbing. Customers were frustrated. So were employees.
Every claim started the same way—submitted online, emailed, or called in. A human had to triage, verify details, request documents, and push it through. Simple claims sat in the same queue as complex ones. The result: inefficiency everywhere.
The idea: create a digital claims agent—one that could instantly process low-risk, rule-based claims without human delay, and escalate only the ones that needed review.
We partnered with Claims Ops, IT, and Legal to design a claims automation model. It reviewed claim type, amount, customer history, and attached documentation—then made an instant decision, with auditability built in.
The AI adjuster now runs in the background—screening and approving over 38,000 claims per month. It flags anomalies, checks for fraud risk, and integrates seamlessly into the existing claims platform. Adjusters still own complex cases—but now, they’re not buried in routine ones.
“We didn’t replace humans. We removed the waste—so people could focus on judgment, not busywork.”
Resolution time dropped from 5.4 days to 1.2 days for eligible claims. NPS for the auto-resolved group rose by 18 points. And adjusters gained back over 7,000 hours annually to spend on complex, high-touch cases that actually need them.
See how Intellimark can help you build a claims agent that scales—without losing the human touch.
Contact USThe insurer automated the routine and refocused human effort on value-added claims:
38,000+ claims auto-processed per month
1.2 day average resolution time (vs. 5.4 days)
+18 NPS points for automated group
7,000+ hours returned to adjusters annually
Some claims need empathy. Some just need efficiency. Now they could deliver both.