ClaimBot AI, Routine Claims Handled in Hours
Handles the routine insurance claims end to end and sends the tricky ones to a person, cutting a two-week wait down to two days.
Most claims are straightforward. They still sit in a queue for two weeks behind the handful that are complicated. This separates the two.
The problem
- The average claim takes around two weeks, mostly spent waiting in a queue
- Staff spend their day on simple claims that need no judgement at all
- Complicated claims wait just as long as easy ones
- Customers ring up to ask where their claim is, which creates more work
How it works
Every claim is checked as it arrives: are the details complete, does the policy cover it, does anything look odd.
Routine claims that pass every check go straight through. Roughly seven in ten do. Anything unusual, expensive or incomplete goes to a person, with a note explaining what caught its attention.
Nothing is ever refused automatically. A refusal always needs a person.
What it does
An insurer handling around a thousand claims a day cut the average time from claim to decision from fourteen days to under two. Staff stopped doing data entry and started handling the difficult cases properly, which is what they were hired for.
Complaints dropped, mostly because people stopped having to ring up and chase.
Where it fits
- Insurers: clear the easy 70% so the queue stops blocking
- Claims teams: spend the day on cases that actually need a human
- Health plans: faster decisions, fewer chasing calls
Built with: Claude, document reading for scanned paperwork, and connections into existing claims systems.
Interested in building something like this?
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