ClaimTriage

ClaimTriage is a web app (with an optional mobile companion for field adjusters) that helps insurers and TPAs triage incoming claims into the right workflow within minutes. It ingests FNOL data, emails, PDFs, photos, and call transcripts, then auto-extracts key fields, flags missing info, and recommends next-best actions (request documents, route to SIU, fast-track payout, assign to specialist). The AI layer scores severity, complexity, and fraud risk using configurable rules plus model signals, but keeps humans in control with clear explanations and audit trails. It also generates claimant/repair-shop outreach messages and maintains a checklist so adjusters stop chasing the same basics. This is not a full claims system replacement; it sits in front of Guidewire/Duck Creek or a TPA portal to reduce cycle time and leakage. Expect heavy integration work and compliance scrutiny, but the value is measurable.