PolicyGPT
The Insurance AI Assistant
of the future

Say goodbye to manual paperwork and hello to PolicyGPT. Our AI solution automates mundane tasks, freeing up time for your team to focus on strategic initiatives and client engagement.
Embrace efficiency with PolicyGPT.

AI Powered Claims Adjuster Bot™

End-to-end claims automation cannot be achieved with traditional programming techniques and requires AI powered software robots that can that recognise dynamic interfaces, read complex documents and make important decisions

Automation Of Simple Claims Is A Very Difficult Problem To Solve

The challenge for straight through processing is
automating policy coverage analysis which is the
foundation of any claim assessment. This is a complex
task that historically has required a desk adjuster to
analyse complex paper based policy forms at claim time.

Redesigning How Insurance Claims Are Processed Is Our Top Priority!

The claims process represents the most acute pain, it is where animosity toward the industry is most commonly cultivated. Re- imaging claims by removing all of the friction, hassle, cost, and delays, is a key driver of our leadership in claim automation.

How The Claim Adjuster Bot Works

Insured/Insurer

Broker or Customer submits claim form via email

RPA

Bot opens email and retrieves the claim form

OCR

Bot extracts relevant data from claim form

RPA/API

Bot retrieves policy data from policy management system

DMN

Bot uses decision engine to validate terms & conditions

RPA/API

Bot performs weather check ( weather claims only)

RPA/API

Bot performs Sanction check

RPA

Bot perfroms ISO claim check

NLU/NLP

Bot identifies the proximate cause

NLP/ML

Bot makes coverage determination

RPA/API/NLG

Bot generates client correspondence

Group 18

Claim Adjuster Bot Key Features

Has already distilled hundreds of thousands of hours of claim adjusters work experience and consistently adjusts to standard each time regardless of the complexity of the claim

Is trained on tens of  thousands of historical claims as well as human adjuster decisions and the algorithms learn from experience by analysing a large variety of different claim
scenarios

Uses a combination of AI technologies and understands claims like a human adjuster
and is able to process claims in real time with unmatched consistency. Harnesses AI at the beginning of the claims process, creating efficiencies for the insurer and greater clarity for the policy holder

Has surpassed human accuracy and is trained to perform many complex claim adjusting tasks faster, cheaper, more accurately and more consistently than humans

Group 7 (2)

Thinks and acts like an experienced insurance professional.

The Claims adjuster Bot can identify proximate cause and perform policy coverage analysis. This is a complex task that to date has required an experienced claims adjuster to analyse the physical policy documents and determine if there is coverage for the loss.

Group 9

Insurer Value Proposition

Reduction in elapsed time for making a coverage determination from 2 or more days to 5 minutes for 80% of claims

50% reduction in loss adjuster expenses by automating the multiple steps and hand-off’s required to finalise a claim

5 x increase in claims processing productivity by increasing the number of claims handled per desk adjuster each day

Focus skilled labour on desk adjusting and reduce the amount of unnecessary investigations and property inspections

Accelerate the speed of response, improving customer service and peace of mind for policy holders.

Make A Coverage Determination On 80% Of Claims Within 5 minutes Of Receiving The Claim

Talk to a Tautona expert