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AI Agent · Claims

Meet your AI Agent for Claim to Policy Comparison

Every new loss raises the same question: is it covered? Your Bevaya AI Agent can read the FNOL, pull the policy in force at the date of loss, and map the facts against your limits, conditions, endorsements, and exclusions — then set up the claim, ready on your adjuster's desk. In minutes, not days.

Trusted by leading P&C carriers, brokers, and TPAs
How your AI Workforce works

From inbox to system of record

Bevaya AI Agents read the work as it arrives, compare it against your guidelines,
recommend the next step, and act, all inside the systems your team already uses.

 
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
What changes

Faster coverage decisions. Lower leakage. Ready-to-handle files.

Reduction in manual intervention for claim setup
90%
ROI in 6 months · Fortune 500 P&C carrier
246%
Hours saved annually on first-notice processing
33,000+
The CFO math

Even a 1–3% reduction in coverage-driven leakage represents millions in recovered value across a commercial book. Bad-faith penalty exposure — typically 30–50% above standard claim value — compounds the case.

Live in production in weeks, not quarters — claims is the fastest Bevaya use case to deploy.

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

Read the full story

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

InsurGPT™ understands policies, not just documents.

Trained on 300M+ insurance documents — ISO-based and proprietary, across CGL, BAP, WC, Property, Cyber, and Umbrella. The reason the coverage finding sits behind a specific clause, a specific endorsement, and a specific policy version — not a paraphrase.

Knows the difference

Between a sublimit and an aggregate. A peril and an exclusion. A Schedule A and a manuscript amendment. The kind of insurance distinctions a generic LLM gets wrong half the time, and a coverage attorney would notice in two seconds.

Sublimit vs. Aggregate | Distinguished

Reads the limit stack as a hierarchy — sublimits, per-occurrence caps, and annual aggregates — and applies the right ceiling to the right loss instead of grabbing whichever number appears first.

Peril vs. Exclusion | Resolved

Parses named perils, all-risk language, and exclusion endorsements together so the AI knows what's covered, what's carved out, and what an endorsement restores back in.

Schedule vs. Manuscript | Reconciled

Recognizes when a manuscript amendment supersedes a Schedule A, when both apply, and when neither controls — the distinction that decides whether a claim is covered at all.

Confidence-scored at the field level

Every coverage decision, every applicable exclusion, every cited clause carries its own score. Low-confidence items route to your specialist with the analysis already prepared.

Per-Field Confidence | Calibrated

Every extracted fact — limit, deductible, named insured, effective date — ships with its own calibrated confidence number, not one blunt score for the whole document.

Specialist Auto-Routing | Routed

Low-confidence items don't stall the file. They route to the right specialist with the analysis already prepared and the source paragraph queued up for review.

Operator-Tuned Thresholds | Tuned

Set the bar where your operation needs it: above auto-processes, below routes to human review. Adjust by line of business, claim size, or coverage type.

Cites every finding to the source

X-Ray Mode highlights exactly where in your policy the AI found the language behind each finding — so your reviewer verifies the source in seconds, not minutes.

X-Ray Mode | Traceable

Click any fact in the coverage finding and jump to the exact page, paragraph, and coordinates where the AI sourced it — no manual searching through 80-page policy PDFs.

Citation by Coordinates | Cited

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

Audit Trail by Default | Defensible

Every coverage finding produces a defensible record: the clause, the policy version, the endorsement stack, and the confidence score behind the decision.

 
What It Does

Claims File Summarization AI Agent

Takes the FNOL with policy attached — or pulls and smart-matches the right policy from your policy admin system, even when the policy isn't named explicitly.
Reads declarations, base form, endorsements, schedules, riders, and manuscript amendments.
Confirms policy period covers date of loss — including retro dates and tail provisions.
Validates named insured, additional insureds, loss payee, and primary / excess / umbrella relationships.
Identifies limits, sublimits, deductibles, SIRs, and aggregates with citation.
Flags every applicable exclusion and modifying endorsement.
Drafts coverage position summary and reservation of rights language.
Sets initial reserves with a documented rationale.
Creates the claim in Guidewire, Salesforce, Duck Creek, or your claims system.
Adds an AI summary note and plain-English adjuster briefing to the file.
Assigns to the right adjuster based on your rules.
Runs 24/7 — your coverage queue doesn't pause for nights, weekends, or CAT season.
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

From the field and from the lab

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.

GET STARTED

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