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AI Agent · Claims

Meet your AI Agent for Claim File Summarization.

Hundreds of documents per claim, across dozens of sources. Claims File Summarization reads every one, triangulates the facts that matter, and produces role-specific briefs your team can act on. No more file dives. No more starting from zero.

Trusted by leading P&C carriers, brokers, and TPAs
How it works

Reads every source. Connects every fact. Summarizes for every role.

Claims File Summarization doesn't summarize one document at a time. It reads across the entire file, triangulates facts between sources, and produces the summary the right person needs.

CLAIM NOTES EXPORT
CONTINENTAL COMMERCIAL INSURANCE — REASSIGNMENT PACKET
CLAIM
NUMBER
78234-
445
 
CLAIM SUMMARY
CLAIM TYPE
Commercial Auto — BI
CURRENT PHASE
Demand Response
DATE OF LOSS
04/21/2025
DATE REPORTED
04/21/2025
DAYS OPEN
367
REASSIGNMENT
DEPARTING ADJUSTER
Priya Venkatesh
Last day 05/02/2026
NEW ADJUSTER
Jennifer Park
Effective 04/22/2026
CRITICAL — ACTIVE DEADLINES ON THIS FILE
IME must be scheduled by 04/25/2026 (3 days)
Policy-limit demand response due 04/30/2026 (8 days)
Priya departs 05/02/2026 (10 days) — file transfer walkthrough 04/28
Reading the entire file
 
 
 
 
 
 
 
Triangulating facts
CLAIM NUMBER
78234-445
0.99
CLAIM TYPE
Commercial Auto — BI
0.99
DAYS OPEN
367
0.99
CURRENT PHASE
Demand response
0.97
NEW ADJUSTER
Jennifer Park (reassigned)
0.99
IME SCHEDULED
Pending authorization
FLAG
Drafting role-specific summaries
 
 
Guidewire
Summary attached
Salesforce
Brief synced
Duck Creek
Summary delivered
Microsoft Teams
Adjuster notified
Refreshing as docs arrive
Reads across the entire claim file
Medical records, bills, demands, correspondence, photos — every source in the file
Reconstructs timelines from documents that arrived piecemeal over months
X-Ray Mode traces every fact back to its source page
Triangulates facts between sources
Matches injury narratives across medical records and demands
Reconciles billing against treatment records
Flags coverage triggers, statute deadlines, and missed dates
Summarizes for every role
Adjuster gets the tactical brief with action items
Supervisor gets the strategic view with reserves and risk indicators
Attorney gets the litigation brief with exposures and deadlines
Delivers into your systems
Pushes the summary into Guidewire, Salesforce, Duck Creek — wherever your team works
Refreshes automatically as new documents arrive
Surfaces subrogation and recovery opportunities by connecting facts across sources
Production reality

Built and proven at scale

Production deployments
115+
Manual processing reduction
85%
Insurance task accuracy
98%+
Bevaya — Case Studies Module

Bevaya’s AI agents reduced our claims indexing from 5 days to under an hour. The accuracy was better than our most experienced staff on day one.

Harry Talbert

Harry Talbert SVP of Information Systems · Eastern Alliance

Read the full story

99% straight-through processing and 246% ROI in just 6 months.

F5

Fortune 500 Carrier Property & Casualty

Read the full story

We evaluated six AI vendors. Bevaya was the only one that understood our underwriting workflows from day one — no six-month education period.

CU

Chief Underwriting Officer Specialty Carrier · $2B+ GDP

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The confidence scoring changed everything. Our reviewers know exactly which items need attention and which can go straight through. We trust it.

DO

Director of Operations Workers’ Compensation Insurer · 74 NSP

Read the full story

Cut COI turnaround from 24 hours to minutes and saved millions.

T5

Top-5 Broker National

Read the full story
THE ENGINE INSIDE

Most AI summarizes one document.
InsurGPT™ understands the whole file.

Claims File Summarization is powered by InsurGPT™, Bevaya's mosaic of specialized models trained on 300M+ real insurance documents. Specialized models read each document type — medical bills, demands, ACORDs, policy forms.

Triangulation across sources

InsurGPT™ doesn't summarize a single document and call it done. It reads the full file, cross-references facts between sources, and reconstructs the story no individual document contains.

Cross-Document Verification | Cross-checked

Pulls the same fact from every source in the claim — police reports, medical narratives, demand letters, FNOL — and reconciles inconsistencies before they reach your queue.

Timeline Reconstruction | Sequenced

Builds a unified chronology of the loss event from scattered timestamps across the entire file, so the story reads in order — not in the order documents arrived.

Conflict Detection | Flagged

Flags contradictions between documents — a date of loss in the FNOL that doesn't match the medical narrative — before they become a coverage dispute.

Role-specific intelligence

Same file, different summaries. An adjuster's brief is not a supervisor's brief is not an attorney's brief. The Agent knows which facts matter to which role and surfaces them accordingly.

Adjuster Brief | Tactical

Tactical view: claim status, current exposure, missing documents, and next-best actions. The working summary an adjuster reads between calls.

Supervisor Brief | Portfolio

Portfolio view: reserves vs. severity, escalation risk, SLA exposure, and which files need a second look before they go sideways.

Litigation Brief | Exposure

Risk view: legal demands, damages cited, exposure vs. policy limits, and the timeline a litigator needs before responding to opposing counsel.

Grounded, never invented

X-Ray Mode shows the source document for every fact in the summary. Adjusters verify in one click. Hallucinated claim details have no path to production.

X-Ray Mode | Traceable

Click any fact in the summary and jump straight to the exact page, paragraph, and coordinates where it was sourced — no manual searching through multi-page PDFs.

Field-Level Citations | Cited

Every extracted value carries its origin — page number, line, and X/Y position on the document — so verification takes seconds, not minutes.

Confidence Thresholds | Calibrated

Every fact ships with a calibrated confidence score. Set the bar where you want it: above auto-processes, below routes to a human reviewer.

 
What It Does

Claims File Summarization AI Agent

Read across every source in the claim file, not one document at a time.
Triangulate facts between medical records, bills, demands, and correspondence.
Produce role-specific summaries for adjuster, supervisor, attorney, and SIU workflows.
Reconstruct timelines from documents that arrive piecemeal over months.
Flag coverage triggers, statutes of limitations, and missed deadlines.
Surface subrogation and recovery opportunities by connecting facts across sources.
Generate brief, medium, or detailed summaries on demand.
Refresh the summary automatically as new documents arrive.
Show grounding for every claim with X-Ray Mode — every fact traceable to its source page.
Operate inside Guidewire, Salesforce, Duck Creek, or your existing claims system.
Surface what matters across the file so adjusters move on the right work first.
Stay audit-ready with every fact cited, sourced, and reproducible.
How it works

An AI layer that sits on top of your existing stack.

Bevaya orchestrates the tools your team already uses. Your stack stays in place. The intelligence layer over it.

01 Sources
Microsoft Outlook
Mailroom / SFTP
Custom API / IPA
02 Bevaya Platform
Bevaya

Bevaya

Intelligence + orchestration layer for insurance workflows

03 Destinations
Systems of record
Guidewire ClaimCenter
Salesforce Industries
Duck Creek Claims
Document management
Alerts
Slack
Microsoft Teams
MORE AI AGENTS FOR CLAIMS

Your AI Workforce, across the claims lifecycle

Underwriting Automation Overview

End-to-end automation across the underwriting lifecycle — from submission intake through quote, bind, and renewal.

Underwriting

Submission Intake

Monitors broker inboxes, classifies submissions, extracts data from ACORDs and supplementals, and populates underwriting systems automatically.

Underwriting

Loss Run Processing

Extracts and normalizes loss data across carriers, identifies trends, and produces structured loss histories ready for underwriting review.

Underwriting

Schedules & SOV Extraction

Reads Statement of Values spreadsheets and property schedules in any format, normalizes the data, and delivers clean structured exposure data.

Underwriting

ACORD Form Extraction

Extracts data from all ACORD forms, validates fields against carrier rules, and pushes clean structured data into underwriting systems.

Underwriting

Policy Renewal Handling

Pulls expiring policy data, refreshes exposures and loss runs, and assembles a complete renewal package for the underwriter.

Underwriting

Policy to Policy Comparison

Compares expiring and renewal policy terms, flags coverage and limit changes, and surfaces material differences for underwriter review.

Underwriting

Claims Automation Overview

End-to-end automation across the claims lifecycle — from FNOL through investigation, settlement, and payment.

Claims

FNOL / FROI Setup

Captures first notice of loss and first report of injury details from email, phone, or portal, structures the data, creates the claim file, and assigns it to the right adjuster.

Claims

Claim to Policy Comparison

Compares loss details against policy terms to surface coverage, exclusions, and obligations before the adjuster makes a call.

Claims

Claim Indexing

Classifies, indexes, and routes claims documents to the right adjuster or team. Handles hundreds of document categories with up to 99% STP.

Claims

Legal Demands Identification & Extraction

Reads demand letters and legal correspondence, extracts allegations, damages, and deadlines, and routes them with full context to the claims team.

Claims

Medical Bill Identification & Extraction

Reads medical bills and provider records, extracts CPT/ICD codes, charges, and dates of service, and links them to the claim for adjuster review.

Claims

Invoice Payment Processing

Processes vendor and provider invoices against claim files, validates against authorized services, and routes for payment approval automatically.

Claims

Claim File Summarization

Reads complex claim files and produces role-specific summaries. Key details, timelines, and action items surfaced for the adjuster.

Claims

Policy Servicing Automation Overview

End-to-end automation across policy servicing — from endorsements and certificates through billing inquiries and audits.

Policy Servicing

Endorsement Processing

Reads endorsement requests, validates against the policy, drafts the change, and routes it for approval and issuance.

Policy Servicing

COI Creation

Generates Certificates of Insurance from policy data, validates additional insured language, and delivers certificates to brokers and insureds automatically.

Policy Servicing

Premium Audit Processing

Classifies audit documents, extracts payroll and classification data, populates systems, and requests missing information from policyholders.

Policy Servicing
Custom AI Agents

Don't see the AI Agent you need?

Bevaya's platform extends to fit your operation. We can build a custom AI Agent for your specific underwriting workflow — trained on Bevaya's insurance-native AI and integrated with your systems.

Resources & insights

More resources on AI in Claims

Case Study - claims
Research

Page stream segmentation with LLMs

How Bevaya Labs approaches a foundational problem in insurance document AI.

Case Study - claims
Case Study

Workers' comp carrier processes claims 100x faster

How indexing automation delivered 432% ROI in 12 months.

2026.06.02-library-webinar-registration-how-to-establish-clear-ai-ownership-in-your-insurance-organization
Architecture

Inside the Bevaya platform architecture

How specialized models, HITL controls, and integrations come together in production.

FAQ

Frequently asked questions

Document summarizers summarize one document at a time. Claims File Summarization reads across the entire claim file — medical records, bills, demands, correspondence, every source — and triangulates facts between them. The output is a synthesized view of the whole claim, not a summary of one piece of paper.

Yes. The Agent generates role-specific summaries from the same underlying file. An adjuster sees action items and key facts. A supervisor sees reserves, risk indicators, and exposure. An attorney sees deadlines, demands, and legal exposure. Same triangulated analysis, different lens for each role.

Works across all P&C claim types — workers' compensation, auto, general liability, professional liability, and more. The Agent is most differentiated on complex, multi-document files where manual review takes days.

Most claim files are summarized in seconds. Complex files with thousands of pages take minutes. Summaries refresh automatically as new documents arrive.

Yes. Summaries can be delivered directly into Guidewire ClaimCenter, Salesforce Industries, Duck Creek, and other major claims systems. Or accessed via email, Slack, or Microsoft Teams.

Every fact is grounded to its source page using X-Ray Mode. Confidence scoring on every extracted field. Your team can review and refine through patented HITL controls, with full audit trails.

Production-ready in weeks, not months. Pre-trained on insurance documents, ready for your file types from day one. Bevaya manages the deployment end-to-end.

Bevaya is SOC 2 Type II certified, with deployment options that meet HIPAA-compatible requirements. All data processing follows your organization's compliance requirements. Visit the Bevaya Trust Center for full security and compliance documentation.

Yes. The Agent can generate summaries for any open claim file in your system on demand, including files that were opened years ago.

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