Claims Is Where the Margin Now Lives
Premium growth is decelerating while severity keeps climbing. The margin insurers need is no longer in the top line. It sits inside the claims operation, in the hours a claim spends waiting rather than moving.
- Severity is structural, not cyclical. Litigation costs and defence spend keep climbing even as premium growth slows.
- Leakage is controllable and it is operational. Inconsistent adjudication and late litigation triage quietly erode margin.
- Claims AI is now a regulated activity, including the vendor’s. Regulators are extending oversight into claims AI, and carriers remain accountable for the AI their vendors run.
Zero
Touch claims process
20%
NPS uplift
70%+
FNOL Automation
35%
Cycle time reduction
40%
Cost reduction
15%
Leakage reduction
Solution Overview
A P&C claim is not slow because people work slowly. It is slow because the claim stops- waiting for a document, a coverage check, a reserve decision, a handoff or a queue. That dead time is where leakage, litigation risk, severity creep and policyholder frustration all compound.
Our Insurance AI Hub changes who advances the claim. Instead of waiting for an adjuster to pick it up, the claim progresses itself through orchestrated AI agents covering intake, triage, document validation, fraud detection, adjudication, compliance and communication. A licensed adjuster is pulled in only where judgment, licensing or the regulator requires one. The Hub runs as an orchestration layer over your existing core, so there is no rip and replace!
- Every claim advances itself and pulls in a licensed adjuster only where judgment, licensing or the regulator requires one
- Explainability and Compliance agents write decision rationale as the claim moves, producing an audit trail on demand
- Sits on top of Guidewire, Duck Creek, EIS or FINEOS without displacing your core
- Backed by licensed US adjudication, FCA certified UK operations and 200+ pre-litigation adjusters
Meet Our Claims AI Agents
Our Partners
How It Works
- Intake and Registration FNOL is captured through Voice AI and digital channels and automatically registered and classified.
- Triage and Validation Coverage verification, policy validation and severity prediction route the claim to the right path.
- Document and Fraud Intelligence Extract.AI and fraud detection agents screen documents, images and invoices for completeness and authenticity, including AI generated fraud.
- Decisioning Adjudication, reserve recommendation and liability assessment agents advance the claim to a decision, escalating to a licensed adjuster only where judgment or regulation requires it.
- Compliance and Communication Explainability and Compliance agents log decision rationale for audit while communication agents keep the policyholder informed at every step.
Unlocking Digital Performance
Provable, not just powered
Agents write their own decision rationale as they work, backed by licensed US adjudication and FCA certified UK operations, so you can answer an examiner rather than explain your vendor.
Expert and Express, not FTE
Express handles the 60 to 70% of claims that are rule based and straight through. Expert keeps your licensed adjusters on the 30 to 40% where judgment actually changes the outcome.
Priced by decision, not headcount
Cost per claim decision at a stated quality and defensibility standard replaces FTE rate benchmarking built for a different operating model.
Fraud detection built for synthetic evidence
Document forensics and provenance checks catch AI generated invoices and records that behavior based scoring alone misses.
Pre-integrated, not build your own
60+ agents come pre-built and pre-integrated with named insurtech partners, so production is measured in a quarter rather than a discovery phase.
Orchestration over your core, not replacement
Cognilink sits on top of Guidewire, Duck Creek, EIS and FINEOS, so you get decision automation without a core migration.