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Seyhun Akyurek
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Insurance

Claim

End-to-end claims processing — FNOL intake, document assessment, damage evaluation, and settlement recommendation.

Azure AI Foundry
Azure Computer Vision
Python
FastAPI
Azure Database for PostgreSQL
Azure Cache for Redis
React
85% faster
Processing Time
70%
Straight-Through
96%
Accuracy
4.8/5
Customer Satisfaction

Project presentation

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Live system presentation

Claim · Agent Mesh

ORCHESTRATORInsuranceFNOLACTIVEAssessmentNODE 02FraudNODE 03SettlementNODE 04CommunicationNODE 0512345678
Step 1Instant

FNOL Intake

Claim reported via phone, web, email, or mobile app.

Multi-channel intakeInformation extractionClaim creationPriority assignment

Technical Design

End-to-end claims processing automation with multi-modal document and damage analysis. AI agents handle FNOL, assessment, and settlement in parallel.

System Components

FNOL Agent

Natural language claim intake

Assessment Engine

Document and damage analysis

Fraud Detector

Pattern-based fraud detection

Settlement Agent

AI-powered settlement recommendations

Communication Service

Automated claimant updates

Data Flow

FNOL Intake
Document Collection
Damage Assessment
Policy Analysis
Fraud Screening
Settlement Recommendation
Approval & Payment

Technology Choice

Azure AI Foundry + LangChain

Azure AI Foundry provides multi-modal analysis for document and damage assessment. LangChain orchestrates complex claims workflows with approval gates.

Alternatives Considered

Shift Technology + Custom ML, Tractable + LlamaIndex

Core Frameworks

Azure AI Foundry

Document and image analysis

LangChain

Claims workflow orchestration

Azure Computer Vision

Damage photo analysis

FastAPI

Claims processing API

Implementation Plan

FNOL Automation

4 weeks
  • Claim intake
  • Information extraction
  • Priority assessment

Assessment System

5 weeks
  • Document analysis
  • Damage evaluation
  • Cost estimation

Settlement Engine

4 weeks
  • Policy matching
  • Settlement calculation
  • Approval routing

Communication & Analytics

3 weeks
  • Status updates
  • Performance tracking
  • Model tuning

Key Milestones

FNOL processing <5 minutes
Straight-through processing >70%
Assessment accuracy >96%
Customer satisfaction >4.8

Risk Mitigation

Human adjuster review for complex claims
Conservative estimates for ambiguous damage
Regular model updates with claim outcomes

Key Features

FNOL Automation

AI-powered first notice of loss intake with natural language processing and guided questions.

Document Assessment

LLM analysis of claim documents — police reports, medical records, repair estimates.

Damage Evaluation

Computer vision analysis of damage photos for automated assessment and cost estimation.

Settlement Recommendation

AI-generated settlement recommendations with policy coverage analysis.

Fraud Detection

Pattern-based fraud detection across claims history and submission patterns.

Customer Communication

Automated status updates and personalized communication throughout claims lifecycle.

How It Works

1

FNOL Intake

Instant

Claim reported via phone, web, email, or mobile app.

Multi-channel intake
Information extraction
Claim creation
Priority assignment
2

Document Collection

1-3 days

AI guides claimant through required documentation.

Document request
Upload guidance
Completeness check
Validation
3

Damage Assessment

< 30 minutes

AI analyzes damage photos and repair estimates.

Photo analysis
Damage scoring
Repair estimation
Total loss check
4

Policy Analysis

< 5 minutes

LLM analyzes policy coverage and applicable terms.

Policy retrieval
Coverage analysis
Deductible calculation
Limit check
5

Fraud Screening

< 10 minutes

Automated fraud detection and investigation trigger.

Pattern analysis
History check
Inconsistency flag
Risk scoring
6

Settlement Recommendation

< 15 minutes

AI generates settlement recommendation with justification.

Settlement calculation
Justification generation
Approval routing
Negotiation support
7

Approval & Payment

1-3 days

Settlement approved and payment processed.

Approval workflow
Payment processing
Confirmation
Documentation
8

Closure & Feedback

Post-resolution

Claim closed with customer satisfaction survey.

Closure confirmation
CSAT survey
Feedback collection
Knowledge update

Multi-Agent Architecture

FNOL Agent

Handles first notice of loss intake with natural language processing.

  • Claim intake
  • Information extraction
  • Guided questioning
  • Priority assessment
  • Route assignment

Assessment Agent

Analyzes claim documents and damage evidence for accurate evaluation.

  • Document analysis
  • Damage assessment
  • Cost estimation
  • Policy matching
  • Coverage verification

Fraud Agent

Detects potentially fraudulent claims using pattern analysis.

  • Pattern detection
  • History analysis
  • Inconsistency flagging
  • Risk scoring
  • Investigation support

Settlement Agent

Generates settlement recommendations based on policy and assessment.

  • Settlement calculation
  • Policy interpretation
  • Negotiation support
  • Approval routing
  • Payment processing

Communication Agent

Manages claimant communications and status updates.

  • Status updates
  • Document requests
  • Decision delivery
  • Sentiment monitoring
  • Escalation triggers

Use Cases

Auto Insurance Claims

Automate vehicle damage assessment and claims processing.

Property Claims

Process property damage claims with photo analysis and cost estimation.

Health Claims

Automate health insurance claims processing and adjudication.

Travel Claims

Process travel insurance claims with document verification.

Liability Claims

Assess liability claims with evidence analysis and policy review.

Workers' Comp

Automate workers' compensation claims intake and processing.

Interested in Claim?

Get in touch to discuss how this solution can be tailored to your needs.