Claims processing automation for a mid-size P&C carrier

Document intake, AI classification, extraction, routing and compliance logging for a carrier processing 10,000+ claims a month.

PythonFastAPIReactPostgreSQLAWSDocker

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80%
Reduction in manual review
95%
Classification accuracy
5,000+
Documents processed monthly
3 wk
Delivery timeline

The client

Mid-market property & casualty carrier

A regional carrier processing over 10,000 claims a month across personal and commercial lines. The claims team was drowning in manual document review, with a growing backlog threatening SLA compliance.

The problem

A manual review bottleneck threatening SLA compliance

Every claim required manual classification, data entry and routing. Adjusters spent more time on admin than on evaluating claims, pushing average processing to five days.

Classification errors caused misrouted claims, duplicate work and compliance gaps that had to be reconciled by hand every month.

5-day average processing time per claim
Manual classification with high error rates
Adjusters spending 60% of time on admin
Monthly compliance reporting reconciled by hand
Backlog threatening state SLA requirements

What we built

5 systems, one platform

Violet marks the parts where the AI does the work. A human approves every consequential change.

Module 01
Intelligent document intake
Email, portal and API intake for PDFs, images, scans and forms — OCR'd and normalised for everything downstream.
- Multi-channel intake
- OCR for scans
- Format normalisation
- Deduplication
Module 02 AI does this
AI document classification
Models trained on historical claims classify FNOL, medical records, estimates and evidence, with confidence scoring and human escalation.
- 95% accuracy
- Confidence thresholds
- Learns from adjuster corrections
- Multi-label support
Module 03 AI does this
Extraction & routing engine
Pulls policy numbers, loss dates, amounts and descriptions, then routes to the right adjuster queue by type, severity and capacity.
- Key-field extraction
- Severity-aware routing
- Workload balancing
- High-value flagging
Module 04
Compliance & audit logging
Every classification, routing decision and adjuster action is logged with lineage — reports ready for state insurance audits.
- Full audit trail
- Regulatory reports
- Decision lineage
- Retention policies
Module 05
Claims analytics dashboard
Volume, cycle time, accuracy and adjuster productivity in real time, with SLA monitoring across the operation.
- Live volume & status
- SLA monitoring
- Accuracy metrics
- Workload views

Stack

PythonFastAPIReactPostgreSQLAWSDockerOCRNLP

Automation Systems·Insurance

Outcome

80% less manual review.

More proof

Other systems we've shipped

Case study

YC S24AI Solutions

The compliance platform for safety-critical hardware

Saphira.ai replaces IBM DOORS-era tooling for robotics, automotive and aerospace teams. We built the core platform: AI document parsing, automated risk assessment and full requirement-to-test traceability.

10×

Faster compliance cycles

Read the case