Industry · Insurance

Claims and policy wording are a retrieval problem.

Insurance runs on documents that contradict each other across versions and territories. That's precisely where grounded retrieval earns its keep — and where an ungrounded model is a mis-selling risk.

  • Generative AI & RAG
  • AI Agents
  • Strategy & Governance

Why now

Claims volume is seasonal and staffing isn't, so cycle time collapses exactly when customers are least patient. Meanwhile the wording that decides a claim sits across policy documents, endorsements and years of amendments. The teams making progress use AI to extract, retrieve and draft — and keep the coverage decision with a human whose reasoning is on the record.

The problem

Where insurance teams lose time today.

  • 01

    Claims intake is manual extraction

    Photos, invoices, police reports and hospital bills arrive as scans. Someone keys them into a form before the claim can even be triaged.

  • 02

    Coverage answers are buried in endorsements

    The base wording says one thing, the endorsement says another, and the version that applies depends on the inception date.

  • 03

    Surge periods break the SLA

    A storm or a policy-renewal wave triples intake overnight and cycle time is the first thing to go.

Constraints

What makes this harder than a generic chatbot.

  • 01

    The coverage decision stays with a human

    The system extracts, retrieves the applicable wording and drafts the reasoning. An adjuster confirms or overrides, and their reasoning is recorded — which is what a complaints process and an ombudsman will ask for.

  • 02

    Version-aware retrieval or nothing

    Every retrieved clause carries its document version and effective date, and queries are scoped by policy inception. Quoting the wrong revision is a regulatory problem, not a UX one.

  • 03

    Extraction accuracy is reported per document type

    A typed invoice and a handwritten claim form are different problems. We publish accuracy per type before you decide what to automate.

Integrations

Systems we wire into.

  • Guidewire & Duck Creek
  • Policy administration systems
  • OCR and layout-aware extraction
  • Salesforce & Zendesk
  • Twilio & WhatsApp Business
  • Snowflake
  • Document management systems

How an engagement is judged

  • A scope small enough to finish, agreed in writing in week one
  • An eval suite built from your own data, versioned in your repo
  • Weekly numbers on the metrics we agreed, including the bad ones
  • Code, IP and repo yours from day one — no proprietary runtime of ours

We publish no per-industry result metrics because almost all client work is under NDA and we won't quote numbers we can't evidence. What we can show is the process and the in-house work on /work, which is public and running.

Pricing ladder

Three ways to start.

Sprint validates · Build productionizes · Retainer scales. The Sprint fee credits toward Build.

detecting…
  1. Step 1 · Validate

    30-day Sprint

    Prove the use case before you commit. Working prototype on real data, eval scores, and an honest signal in 30 days. Fixed scope, fixed fee.

    $4,500 fixed

    Learn more
  2. Most teams land here

    Step 2 · Build

    Prototype → Production

    Turn the validated prototype into a real product. Auth, DB, payments, tests, monitoring, deployed. Sprint fee credits toward this engagement.

    from $6,000

    Learn more
  3. Step 3 · Scale

    Managed Retainer

    Ongoing operation, eval cycles, model iteration, and cost guards. We keep the system improving so your team can focus on growth.

    from $750/mo

    Learn more

FAQ

AI in insurance: the questions we get.

  • Can AI decide a claim?

    It shouldn't, and we won't build it that way. It can assemble the evidence, retrieve the applicable clause and draft the reasoning for an adjuster — which removes most of the elapsed time without removing the accountable decision.

  • Our documents are decades of scanned PDFs. Is that workable?

    Yes, and it's the normal starting point. Expect the first phase to be extraction quality rather than answering — we report per-document-type accuracy so you know what's safe to build on before anything is automated.

  • How do you handle regional wording differences?

    Territory and effective date are retrieval filters, not prompt suggestions. A query for a Maharashtra policy written in 2023 cannot return a 2026 national endorsement.

Contact

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admin@neuroxai.com · +91 70149 99768

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