Case Study  ·  Insurance

Claims Processing Cycle Time Reduced by 60% with Full Adjuster Oversight

The Challenge

An insurance group was processing personal lines claims through a largely manual adjuster workflow. Average cycle time from first notice of loss to settlement was 11 days for straightforward claims. Adjuster capacity was a binding constraint on throughput, and the group was facing increasing customer complaints about processing times. The compliance and governance team required that all claims decisions remain auditable and that human adjusters retain oversight of all material decisions.

The Approach

Almanor AI deployed a claims automation system that handled intake, document extraction, coverage verification, liability assessment for straightforward claims, and settlement calculation — with human adjuster review at configurable thresholds. The system was built on 24 months of historical claims data, giving it a detailed model of the group's specific claims patterns, coverage interpretations, and settlement ranges. Deployment was phased over four weeks.

The Results

Average cycle time fell from 11 days to 4.4 days for standard claims. 68% of personal lines claims were processed straight-through without adjuster intervention, with adjusters reviewing and approving AI-generated assessments rather than conducting assessments manually. Adjuster capacity effectively tripled, allowing the group to handle significantly higher volume without additional headcount. All claims decisions carry a complete audit trail meeting the group's governance and regulatory requirements.