Claims Triage
Route complexity, severity, and expertise requirements from day one. Reduce inconsistent first-pass handling and senior adjuster overload.
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INSURANCE
Claims decision layer for Guidewire and Duck Creek
Add expert-level triage, coverage reasoning, and subrogation detection on top of your existing CMS — without replacing Guidewire, Duck Creek, or your core claims stack.
Pilot design targets — derived from benchmarking against historical claims workflows and expert-reviewed decision datasets. 90-day pilot framework and benchmarking methodology.
WHERE WE START
Three claims decisions that drive outcomes
Carriers pilot triage, coverage reasoning, and subrogation first — then expand repeatable decisions across the operation when outcomes are verified.
Coverage Reasoning
Match policy language to claim facts with cited provisions on every coverage call — exportable for compliance and audit review.
Subrogation Detection
Surface third-party liability and recovery signals early, before opportunities are missed in high-volume queues.
CMS Overlay
Integrates with Guidewire ClaimCenter, Duck Creek, Majesco, and Snapsheet via API and webhooks. Your CMS stays the system of record.
Built as an overlay — not a Guidewire replacement
Guidewire and Duck Creek partners tell us the same thing: carriers need intelligence on top of existing workflows, not another rip-and-replace. IntelliHuman adds decision infrastructure where judgment matters most — triage, coverage calls, and subrogation — while your CMS remains the system of record.
- FNOL, policy data, and adjuster queues stay in your CMS
- Every decision includes cited provisions and exportable rationale
- REST API, webhooks, and pre-built Guidewire / Duck Creek connectors
- 90-day pilot framework with before/after KPI measurement
Claims workflow resources
Deep dives on triage, coverage, subrogation, and compliance — for claims leaders and ecosystem partners.
Claims Triage Workflow
Prioritization and routing logic
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Coverage Determination
Policy language and coverage reasoning
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Subrogation Identification
Third-party liability detection
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IntelliHuman + Guidewire
Complementary roles in claims architecture
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Insurance Compliance
Regulatory posture and audit trails
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90-Day Claims Pilot
Verify outcomes before enterprise rollout
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Insurance claims FAQ
Verify claims decision infrastructure in a 90-day pilot
Start with triage, coverage reasoning, or subrogation — measured against your baselines, with no long-term commitment.