Regional insurance carrier
Claims triage that cites the policy in plain English
A multi-state property and casualty insurer was losing adjuster time to manual policy lookups. Rowbase built a source-grounded assistant that triages first-notice-of-loss submissions against the right policy language, with the exact clause attached to every answer.
62%
faster first-touch on FNOL claims
01 · Challenge
Where the work was getting stuck
Adjusters were spending the first 20–40 minutes of every new claim digging through PDF policies, endorsements, and prior correspondence to figure out what was actually covered. Each carrier line had its own policy template, and the rules for coverage exceptions lived in tribal knowledge across the claims org. The team had tried a generic AI chat tool the year before — it sounded confident and was wrong often enough that adjusters stopped trusting it.
02 · Approach
How we built it
- 01Ingested the full policy library, endorsements, state-specific addenda, and the prior two years of resolved claims into a client-owned context layer.
- 02Built a triage agent that answers coverage questions only against the relevant policy version, with line-level citations adjusters can click through to verify.
- 03Added a review surface where senior adjusters approve novel coverage interpretations before they propagate, with the decision flowing back into the context layer.
- 04Wired the agent into the existing claims-management system so it shows up where the work already happens, not as a separate tab.
03 · Outcome
What changed
- First-touch time on new claims dropped from a 38-minute median to under 15 minutes.
- Adjuster trust held: every answer surfaces the policy clause it relied on, and supervisors review edge cases instead of rubber-stamping.
- The context layer now compounds — every resolved edge case improves the next triage.
Systems & sources involved
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