AI for insurance: claims handled with human validation
WYnova applies artificial intelligence in insurance to prepare decisions on simple claims and flag signs of fraud, while the final decision, and its audit trail, remain with the claims handler.
Contact WYnovaCommon challenges in the sector
Claim notifications and documents analysed by hand, step by step.
Fraud is difficult to detect without a model that cross-checks the data for each claim.
Customers left without a response while the claim awaits analysis.
Claims handling using AI and human validation
Challenge
Speed up the decision on each claim without losing technical rigour or compliance with the policy terms.
Proposed approach
The customer submits documents and photographs. AI extracts the information, checks it against the policy terms, flags signs of fraud and prepares the proposed decision. A claims handler validates each decision, which is recorded in the audit trail.
Expected result
Faster decisions on simple claims and suspicious cases referred for analysis, with each decision traceable to the source documents.
Technical areas: GenAI, OCR · Parsing, Rules, Human validation
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