AI Automation for Insurance

Our AI manages claims from first notification of loss (FNOL) through to settlement. When a claim is lodged — via phone, email, web form, or broker portal — AI extracts claim details, categorises the claim type, performs initial coverage verification against the policy schedule, and creates the claim file in your claims management system. For straightforward claims (e.g., windscreen replacement, minor property damage under $5,000), AI can auto-approve and initiate payment. Complex claims are triaged to the appropriate claims team with a pre-populated assessment pack including policy details, coverage analysis, and loss history.

Yes, our compliance automation generates the reports required by APRA (Australian Prudential Regulation Authority) and ASIC (Australian Securities and Investments Commission). This includes APRA quarterly statistical reporting, internal dispute resolution (IDR) reporting, breach reporting under the Financial Accountability Regime, and AFCA (Australian Financial Complaints Authority) data reporting. The system maintains audit trails for all automated decisions and produces compliance dashboards that give your compliance team real-time visibility into regulatory obligations. All reports are generated in the formats and timelines mandated by each regulator.

AI handles the data-intensive preparation that underwriters currently spend hours on. For a new commercial property risk, AI gathers property data (from CoreLogic and council records), loss history (from the Insurance Reference Service), industry risk profiles, and weather exposure data, then produces a pre-underwriting assessment with recommended premium ranges. The underwriter reviews this assessment and makes the final decision. For simple personal lines (home, motor, travel), AI can auto-rate and auto-bind within defined authority limits, with referral triggers for anything outside those limits.

We integrate with major Australian insurance platforms including Sunrise (by SSP), Guidewire, Duck Creek, Open GI, and broker platforms like Steadfast INSIGHT, AUB Group systems, and BrokerEngine. For claims, we connect to Claim Central, Wilbur, and specialty claims platforms. Data feeds from CoreLogic, Insurance Reference Service (IRS), and Bureau of Meteorology are incorporated for underwriting and risk assessment. Most platform integrations are configured within 1-2 weeks using official APIs and data connectors.

Our renewal automation begins 90 days before policy expiry. AI analyses the policyholder profile, claims history, market rates, and risk changes to generate a renewal recommendation. Low-risk renewals (no claims, no material changes) receive automatic renewal notices with updated terms. Medium-risk renewals are flagged for underwriter review with a recommended premium. High-risk renewals (multiple claims, significant risk changes) are escalated to the retention team with a customer value analysis. Automated renewal reminders at 60, 30, and 14 days reduce lapse rates by 15-25% compared to single-notice approaches.

Our fraud detection analyses claims against multiple signals: claim timing patterns, claimant history, repair shop networks, medical provider patterns, and policy inception-to-claim intervals. Claims that trigger fraud indicators are flagged for investigation rather than being auto-processed. The system learns from confirmed fraud cases in your portfolio to improve detection accuracy over time. Importantly, AI provides the flags and evidence — human investigators make the final determination. This approach typically identifies 3-5x more suspicious claims than manual review while reducing false positives.

A broker-focused package covering policy administration, renewal management, and client communication deploys in 2-3 weeks. An insurer package adding claims automation and underwriting support takes 4-6 weeks due to the complexity of claims management system integration and underwriting rule configuration. Full-stack automation including compliance reporting, fraud detection, and portfolio analytics takes 8-12 weeks. We implement in phases, starting with the highest-volume, lowest-complexity processes to deliver quick wins while building toward comprehensive automation.