Calculate the ROI of AI Automation for Your Agency
AI automation delivers ROI by cutting claims first-response time from hours to under 15 minutes. It also reduces policy comparison and renewal prep work by more than 10 hours per week.
We built a claims triage system for a 6-adjuster agency handling 150 FNOL reports per week. The system went live in 4 weeks, cutting their average first-response time from 4 hours to 12 minutes. This allowed their team to focus on high-severity claims instead of administrative sorting.
The actual return depends on your agency's specific bottlenecks. An agency with high claims volume sees the biggest lift from automated triage. One focused on new business gains more from instant policy comparisons. The complexity is determined by your Agency Management System (AMS) and the number of carrier portals we need to access.
What Problem Does This Solve?
Most agencies try to solve this with people. An admin spends their morning reading the inbox, manually deciding if a First Notice of Loss (FNOL) is a simple glass claim or a major commercial liability issue, then forwarding it. A high-severity claim can sit for hours if that person is on a call, and this manual routing introduces inconsistent assignments and data entry errors.
Built-in AMS workflows in systems like Applied Epic or HawkSoft can trigger reminders, but they cannot intelligently parse an unstructured email. They can't read an FNOL report, score its severity, and route it based on content. This leaves the highest-value initial step entirely manual. You are paying for a powerful system but still using it like a simple contact database for your most urgent tasks.
Off-the-shelf AI tools for insurance are built for national carriers, not a 15-person independent agency. They demand enterprise-level pricing, long implementation cycles, and a one-size-fits-all model. They fail to integrate with your specific workflows and can't be customized to your agency's unique routing rules, forcing you to change your process to fit their software.
How Does It Work?
We start by connecting to your data sources. For claims triage, this means setting up an AWS SES webhook to receive emails from your dedicated claims inbox in real time. We use the official APIs to establish a connection with your AMS, whether it is Applied Epic, Vertafore, or HawkSoft. We analyze the last 6 months of claims data to map your existing routing patterns and outcomes.
The core logic runs on AWS Lambda. When an email arrives, the function triggers, passing the content to the Claude API. We use a carefully engineered prompt to have the model extract structured data like policy number, claimant details, and incident description. The model then scores the claim's severity on a 1-10 scale. Every API call, response, and score is logged to a Supabase table for a complete audit trail.
Once scored, a FastAPI service contains the routing logic. It queries your AMS to determine the appropriate adjuster based on claim type, licensing, and current caseload. The system generates a summary, recommends next steps, and creates a new activity or task directly in the adjuster's AMS dashboard. The entire process, from email receipt to the adjuster being notified in their AMS, completes in under 90 seconds.
We build a human-in-the-loop process for high-stakes decisions. Any claim scored 8/10 or higher automatically posts an alert to a private Slack channel for a manager to approve before assignment. All system actions are logged with structured data using structlog and sent to AWS CloudWatch. This provides full visibility and allows us to set up alerts for any anomalies. Monthly AWS hosting for processing over 1,000 claims is typically under $50.
What Are the Key Benefits?
First Response in 12 Minutes, Not 4 Hours
Our triage system parses, scores, and routes incoming FNOL reports automatically. High-severity claims are flagged for an adjuster in minutes, not buried in an inbox.
Pay for a Build, Not Per-Adjuster Seats
A one-time project cost with minimal monthly AWS hosting fees. You are not locked into a SaaS subscription that penalizes you for growing your team.
You Get the Keys to the GitHub Repo
We deliver the complete Python source code, deployment scripts, and a runbook. The system is yours to modify or hand off to an in-house developer.
Slack Alerts When Confidence is Low
The system monitors its own performance. If the Claude API returns a low-confidence score on a claim, it automatically flags it for human review in Slack.
Works Natively Inside Your AMS
We build direct API integrations with Applied Epic, Vertafore, and HawkSoft. Adjusters work from their existing system, no new software to learn.
What Does the Process Look Like?
System Scoping (Week 1)
You provide read-only access to your AMS and sample FNOL reports. We deliver a detailed technical spec outlining the exact triage logic and integration points.
Core Engine Build (Weeks 2-3)
We build the core parsing and routing logic using the Claude API and FastAPI. You receive a link to a staging environment to test with sample claims.
AMS Integration & Deployment (Week 4)
We connect the engine to your live AMS and deploy it on AWS Lambda. You receive deployment credentials and the full source code in your private GitHub repo.
Monitoring & Handoff (Weeks 5-8)
We monitor the live system, fine-tune the prompts, and handle any exceptions. You receive a final runbook with operational instructions and monitoring dashboard access.
Frequently Asked Questions
- How is the cost and timeline determined?
- Cost depends on two factors: the number of systems to integrate (e.g., just email vs. email + AMS + carrier portal) and the complexity of your routing rules. A standard claims triage build for one AMS takes 4-6 weeks. Policy comparison systems that need to access multiple carrier portals can take longer. We provide a fixed-price quote after our initial discovery call.
- What happens if the AI misinterprets a claim?
- Every AI decision is logged with a confidence score. For critical tasks, we set a threshold. If the score is below 95%, the system routes it to a human review queue instead of an adjuster. This prevents errors on ambiguous reports. The system also has a health check that alerts us if an API like Claude is down, preventing data loss.
- How is this different from using an offshore virtual assistant?
- A VA follows a checklist; our system executes code. A VA gets sick or goes on vacation. The AI system runs 24/7 with 99.9% uptime. More importantly, the system's performance is measurable and auditable. You have a log of every decision, which is critical for compliance and Errors and Omissions (E&O) insurance.
- How is my agency's and my clients' data handled?
- We never store sensitive client data long-term. Data passes through our system on AWS Lambda during processing and is then written to your AMS. We use Supabase only for logging metadata, like API response times and confidence scores, never PII. You own the cloud account and the data. We can sign a BAA and adhere to your security protocols.
- Besides claims, what other processes can be automated?
- Renewal processing is a common one. We build systems that automatically track renewal dates, collect necessary documents from clients, and pre-fill applications. We've also built policy comparison tools that pull data from carrier portals, normalize it, and generate a side-by-side PDF highlighting coverage gaps for a new prospect in under two minutes.
- What if my agency uses a less common AMS?
- If your AMS has a documented API or supports webhooks, we can almost always integrate with it. For systems without an API, we can sometimes use scheduled data exports or other methods. During the discovery call, we will assess your specific AMS's capabilities. We have direct experience with Applied Epic, Vertafore, and HawkSoft, but the architecture applies to others.
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