Claims triage
Cases assembled, coverage applied, settlement proposed and routed to the adjuster with judgment calls highlighted.
Industry
Insurance
Claims triage, document extraction, audit-ready evidence.
The sector reality
How the sector operates today.
Insurance pays for documented promises. Every claim, every quote, every policy change has to be processed with enough evidence to defend the decision later — to the customer, the regulator, or the reinsurer.
Claims are the moment of truth. The customer is at their worst — accident, loss, illness — and the operation has to be at its best: fast, accurate, fair. The gap between the brochure and the experience is where reputation gets made or lost.
Document intake is overwhelming. Police reports, medical records, photos, receipts, third-party correspondence — each claim assembling a small archive that someone has to read, classify and cross-reference.
Fraud is real and expensive. Patterns hide in volume; the analyst who would spot them is busy clearing the queue. Detection happens after the payment too often.
Where Sommatic fits
A cognitive layer that shapes itself to your operation.
Sommatic absorbs the document intake. Police reports, medical notes, photos and third-party correspondence get extracted, classified and tied to the claim — minutes after they arrive, not days.
Claims triage runs at the speed customers need without skipping a step. The cognitive layer assembles the case, applies coverage rules, calculates the proposed settlement and routes the judgment calls to the adjuster.
Fraud signals surface where they used to disappear. Patterns across claims, providers, repair shops and reported incidents become visible — not as a quarterly project but as a live operational signal.
Audit-grade evidence comes free. Every decision carries actor, rule, input and output. Reinsurer and regulator queries become exports, not anxiety.
Common workflows
The first things the cognitive layer starts operating.
Document extraction
Police reports, medical records, invoices and photos extracted into structured data tied to the claim.
Fraud signals
Patterns across claims, providers and reported incidents surfaced live — not as quarterly hindsight.
Quote & policy ops
Quote assembly, policy changes and renewal workflows run consistently across products and channels.
Audit & reinsurer evidence
Decision chains and case files exported on demand for regulators, auditors and reinsurer reviews.
What you will see change
Three things your team will notice first.
Claims close faster, fairer
Cycle times compress without compromising review. The moment-of-truth experience finally matches the brochure.
Fraud surfaces before payment
Patterns become live signals. Loss-ratio improvement compounds quarter after quarter.
Reinsurer queries stop being projects
Evidence chains export on demand. The reinsurance conversation becomes data, not a quarterly scramble.
Where you start
Your recommended entry point.
Start with claims triage. Add document extraction and audit-grade evidence once the first line of review trusts it.