Claims processing, underwriting analysis, and policy administration — powered by agents that are governed by deterministic policy, audited at every step, and deployed inside your VPC.
Every challenge in insurance AI — claims accuracy, underwriting consistency, fraud detection — is addressed by a specific Metaprise capability.
Adjusters manually review photos, police reports, medical records, and policy terms for each claim — creating backlogs that frustrate policyholders and increase costs.
Automated claims processing with fact verification against policy terms and submitted evidence. Every claim follows an 8-state Mission — from first notice through settlement — with complete audit trail.
Different underwriters apply risk criteria differently, leading to inconsistent pricing, adverse selection, and regulatory risk.
Deterministic underwriting with consistent risk criteria applied every time. Authority Graph ensures standard risks auto-approve at L1, complex risks escalate to senior underwriters at L2-L3.
Insurance fraud costs the industry billions annually. Manual review catches only obvious patterns while sophisticated fraud schemes go undetected.
AI-powered fraud detection trained on 8+ years of claims data. Cross-references claim details against historical patterns, provider networks, and known fraud indicators. Every analysis audited through SHA-256 hash-chained AuditChain.
From first notice of loss to policy renewal — governed agents handling real insurance workflows.
Automated assessment · Authority L2
Automates claim intake, damage assessment, coverage verification, and settlement calculation. Deterministic policy matching ensures consistent, fair outcomes.
Risk assessment · Authority L2
Analyzes applications, medical records, and risk factors to produce consistent underwriting recommendations. Every decision auditable through AuditChain.
Lifecycle management · Authority L1
Manages policy issuance, endorsements, renewals, and cancellations. Automates routine changes while escalating complex modifications to underwriters.
Pattern detection · Authority L2
Cross-references claim details against historical fraud patterns, provider networks, and geographic indicators. Escalates suspicious claims for human review.
Policyholder engagement · Authority L1
Handles policy inquiries, claim status updates, and coverage questions. Provides accurate, consistent responses with full conversation audit trail.
Filing & reporting · Authority L3
Generates state regulatory filings, rate justification documentation, and compliance reports. Complete chain of evidence for regulatory examination.
Insurance companies need control over sensitive policyholder and claims data. Metaprise offers three deployment modes — with Hybrid recommended for insurance environments.