Insurance Automation

Automated First Notice of Loss (FNOL) processing handles the structured data work from the moment a claim is reported. Intake automation extracts claim data from email, web forms, phone call transcriptions, and document uploads -- populating claim records in your Guidewire ClaimCenter, Duck Creek Claims, or custom claims management system without manual rekeying. ACORD 125, 126, and 127 form data is parsed and mapped to your internal claim data model automatically.

ISO ClaimSearch and CLUE (Comprehensive Loss Underwriting Exchange) queries are triggered at intake to retrieve prior loss history, identifying claimants with previous claims across carriers before the adjuster reviews the file. Verisk ISO enrichment data -- property characteristics, vehicle data, replacement cost estimates -- is pulled and attached to the claim record at creation.

Subrogation detection logic flags claims where third-party recovery may be available based on loss type, circumstances, and coverage details, routing them to the subrogation team at intake rather than weeks later. STP (Straight-Through Processing) rate -- the percentage of claims that close without adjuster intervention -- is tracked as the primary automation performance metric. Most claims automation programmes achieve 70-85% STP on simple claim types within six months. Settlement letter generation for straightforward claims closes the file automatically; complex and high-value claims are routed to adjusters with all enrichment data pre-loaded.

Automated renewal processing works through your Guidewire PolicyCenter, Duck Creek Policy, Applied Epic, or custom policy administration system to generate renewal packs, check for material changes in risk data since the prior term, recalculate premium based on current rating factors, and trigger broker or direct customer communication on the renewal schedule your operations team defines.

ACORD-format policy documents are generated automatically for standard lines. Mid-term endorsement processing updates policy records, recalculates pro-rata or short-rate premium adjustments, issues amended declarations pages and endorsement documents, and posts the premium change to your billing system -- all without a policy admin touching the transaction for straightforward endorsement types.

Cancellation and reinstatement workflows follow your jurisdiction-specific notice requirements, generating the correct statutory notices with the required notice periods. Reinstatement after lapse processes the past-due premium, reinstates coverage on the correct retroactive date, and issues a reinstatement certificate. The policy admin backlog that builds during peak renewal periods clears automatically because the structured processing work doesn't require a human in the loop. Renewal lapse rates fall because no renewal reaches its expiry date without the correct communication sequence having been sent to the broker or policyholder.

Automated underwriting data collection pulls from the third-party sources your underwriting team currently accesses manually -- Verisk ISO enrichment data for property risk characteristics and replacement cost estimates, credit bureau reports for personal lines risk scoring, weather and catastrophe model outputs for property and cat-exposed risks, sanctions and PEP screening for trade credit and specialty lines, and public records for commercial underwriting.

Carrier and reinsurer portal submissions are pre-populated with risk data from your policy system and the collected third-party sources. Where carriers accept structured data submissions, ACORD XML formats are generated automatically. Where portal entry is still required, UI automation handles the repetitive data entry across carrier portals so your underwriting assistants are not re-keying data that already exists in your system.

Risk scoring outputs from Verisk ISO or your internal models are formatted into the underwriting review pack alongside the raw data inputs, so underwriters see both the score and the supporting evidence. The data gathering that currently requires underwriting assistants to log into six or eight separate systems for each submission happens automatically in parallel -- carrier submissions go out faster, underwriters review complete packs rather than incomplete ones, and the capacity constraint shifts from data collection to actual underwriting judgment.

Automated regulatory reporting assembles submissions from your policy administration, claims management, and financial systems without a compliance team spending days extracting and reconciling data. For Lloyd's managing agents and syndicates, bordereaux reporting in the Lloyd's-specified format is generated automatically from policy and claims data on the required submission schedule. NAIC XBRL financial data tagging for US statutory reporting is handled programmatically, with validation against the NAIC taxonomy before submission.

Solvency II reporting for EU and UK insurers -- Solvency Capital Requirement calculations, Best Estimate Liability data, and quantitative reporting templates (QRTs) -- is assembled from your reserving and financial systems with data transformation mapped to the EIOPA submission specifications. FCA regulatory returns are generated from your policy and financial data on the FCA submission calendar.

Data extraction, transformation, and validation against the submission template runs automatically. Validation checks flag data quality issues -- missing values, out-of-range figures, referential integrity errors between related schedules -- before the output reaches your compliance team, so they spend their time reviewing and approving a clean submission rather than investigating why the data doesn't balance. Deadline tracking ensures submissions are prepared and reviewed with time before the regulatory deadline, not assembled the night before.

Automated broker communication workflows handle the transaction-by-transaction communication that currently requires your operations team to prepare and send individually. Quote delivery with ACORD-format documentation attached, policy documents distributed on binding confirmation, renewal packs sent on the renewal schedule defined per broker, and commission statements generated on your payment cycle -- all triggered automatically by the relevant policy event in your system.

New business submissions received via email, ACORD XML, or broker portal are acknowledged automatically with a submission reference number and expected turnaround time, so brokers are not chasing your underwriting team for confirmation that the submission was received. Submission tracking gives your underwriters a queue view showing which submissions are within SLA and which are approaching breach.

Broker portal updates -- policy status changes, endorsement confirmations, claims status updates -- are pushed to the broker's portal view in real time when the underlying event occurs in your systems, rather than waiting for a batch update overnight. The communication that currently requires manual preparation per transaction runs on event triggers from your policy and claims systems, keeping your distribution partners informed without your operations team logging the interaction for each one. Commission disputes and reconciliation queries reduce because brokers see the same transaction data you do.

Automated fraud screening data gathering runs at claim creation and enriches the claim record before the adjuster opens it. ISO ClaimSearch queries retrieve the claimant's prior loss history across participating carriers -- a claimant with three prior glass claims in 18 months is flagged before the adjuster spends time on the file. CLUE reports for property and auto lines surface the property or vehicle's claim history regardless of current ownership. Sanctions and watchlist screening checks claimant details against OFAC, PEP databases, and industry-specific fraud watchlists.

Social media signal collection and link analysis -- connections between claimants, attorneys, repair facilities, or medical providers that appear across multiple claims -- can be automated for programmes where organised fraud is a material exposure. Vehicle history data (for auto claims), contractor licensing verification (for property claims), and medical provider billing pattern data are pulled and attached to the relevant claim type automatically.

Fraud indicator scores -- combining prior claim frequency, network connections, claim characteristics, and timing -- are delivered to the claims handler alongside the claim record at intake, presented as a risk score with the supporting evidence listed. The SIU referral threshold is configurable so high-score claims route directly to your special investigations unit without adjuster triage. Investigators assess the flagged data rather than spending time gathering it, which is where fraud automation creates the most capacity.