Automate Claims Processing for Your Small Agency

Small agencies run on an Agency Management System (AMS) like Applied Epic, Vertafore, or HawkSoft. These platforms are excellent systems of record but poor workflow engines. Their 'automation' capabilities are often limited to task reminders or canned email responses. They cannot read the unstructured text in an email or a PDF attachment to make an intelligent decision.

Consider a 10-person agency that receives a PDF First Notice of Loss (FNOL) for water damage. A staff member must open the file, manually identify the policy number, client name, and incident details. They then log into the AMS, find the client, create a new claim record, and copy-paste each field. This 15-minute task is repeated dozens of times a week, creating a bottleneck that delays response to urgent claims and introduces a high risk of data entry errors.

The structural problem is that an AMS is designed for structured data entry, not unstructured data interpretation. These platforms lack native connections to the large language models (LLMs) required for this task. Off-the-shelf email parsing tools fail because they are generic; they do not understand insurance-specific terminology and cannot handle the wide variation in FNOL formats from different carriers.

The result is a slow, expensive, and error-prone manual process. High-severity claims can sit unaddressed in an inbox for hours, while experienced staff spend their time on low-value data entry. This bottleneck prevents the agency from scaling its claims volume without proportionally increasing administrative headcount.

The project would begin with an audit of your current claims intake process. Syntora would review 20-30 historical FNOL reports (emails and attachments) to understand the format variations. We would map out your severity scoring logic and the routing rules for different claim types and adjusters. This discovery phase produces a detailed technical specification for your approval before any code is written.

The core of the system would be a Python service running on AWS Lambda, triggered by new emails. The service would use the Claude API to parse the unstructured text and attachments, extracting entities like policy number, date of loss, and incident description. This extracted data is then structured into a JSON object. A FastAPI endpoint would apply your business logic to score severity from 0-100 and determine the correct adjuster.

The delivered system would automatically create a claim record in your AMS via its API within 90 seconds of an FNOL email arriving. The system can process up to 500 claims per day with typical cloud hosting costs under $50 per month. You receive the full source code, deployment scripts for AWS, and a runbook detailing how to update routing rules. Adjusters see new claims appear in their queue without any manual data entry.