IntelliHuman AVI Claims
Expert reasoning for the modern claims department
Expert reasoning engine for claim triage, coverage reasoning, and subrogation signals. Built from real adjuster expertise. Designed for audit-ready decisions.
Reduced average handling time through intelligent automation
High accuracy on coverage determinations with expert reasoning
Enhanced subrogation opportunity identification
Full audit trail compliance for every decision
The Claims Challenge
Claims departments face mounting pressure to do more with less—while expertise walks out the door every day.
Majority
of adjuster time spent on routine tasks that AI should handle
Significant
cost impact of mishandled subrogation opportunities
Many
claims require senior review due to inconsistent triage
Decades
of expertise walks out the door when adjusters retire
What AVI Claims Does
Six core capabilities that transform how your claims department operates.
Claim Triage Scoring
Instantly prioritize incoming claims based on complexity, severity, and expertise required. Route to the right adjuster from day one.
Coverage Reasoning
Analyze policy language against claim facts to determine coverage applicability. Cite specific provisions for every decision.
Subrogation Detection
Identify recovery opportunities that human review might miss. Flag third-party liability signals automatically.
Reserve Estimation
Generate accurate initial reserves based on claim characteristics and historical patterns from experienced adjusters.
Fraud Signals
Surface red flags and anomalies that warrant investigation. Based on patterns from fraud investigators.
Expert Routing
Match complex claims to adjusters with relevant expertise. Ensure specialized claims get specialized attention.
How We Compare
AVI Claims vs. common solutions in insurance claims processing
* General AI requires significant prompt engineering and lacks insurance-specific accuracy guarantees
How AVI Claims Works
From first notice of loss to resolution recommendation—AVI Claims reasons through every step like your best adjuster.
Watch how AVI Claims transforms claims processing
Claim Intake
FNOL data flows into AVI Claims. Documents, photos, and descriptions are parsed and structured.
Policy Match
AVI Claims matches claim facts against policy terms, identifying applicable coverages and exclusions.
Triage Score
Claims receive priority scores based on complexity, value, and required expertise level.
Reasoning Output
Coverage recommendations, subrogation signals, and reserve estimates with full reasoning trails.
Expert Handoff
Complex claims route to senior adjusters with full context. Simple claims fast-track to resolution.
Every Decision Has an Audit Trail
AVI Claims documents its reasoning for every coverage determination, triage decision, and subrogation flag. When regulators ask "why did you decide that?"—you have the answer.
- Policy provision citations
- Fact-to-coverage mapping
- Decision confidence scores
- Expert knowledge sources
Integrations
AVI Claims connects with your existing claims management systems. See our integration options and enterprise capabilities.
Powered by the IntelliHuman Brain
AVI Claims is built on our proprietary IntelliHuman Brain, trained on expertise from Subject Matter Experts. Learn more about our insurance solutions and enterprise platform. It's trained on expertise from seasoned claims adjusters, SIU investigators, and coverage attorneys. It reasons like your best people—and gets smarter with every decision.
Learn About the IntelliHuman BrainInsurance Claims Workflows
See how IntelliHuman automates complex claims workflows with explainable AI
Claims Triage Workflow
How AI automates intelligent claim prioritization and routing based on complexity and expertise required
Coverage Determination Workflow
How AI analyzes policy language against claim facts to determine coverage applicability
Subrogation Identification Workflow
How AI detects third-party liability and recovery opportunities that manual review might miss
SIU Referral Workflow
How AI identifies fraud indicators and routes suspicious claims to Special Investigation Units
Reserve Estimation Workflow
How AI calculates initial claim reserves using historical comparables and claim characteristics
Insurance Compliance Posture
Learn how IntelliHuman ensures regulatory compliance and fair claims handling practices
Key Concepts in Insurance AI
Understand the core terminology behind intelligent claims processing
Claims Triage
Intelligent prioritization of incoming claims
Coverage Reasoning
AI analysis of policy vs. claim facts
Subrogation Detection
Automated recovery opportunity identification
Fraud Detection
AI-powered fraud pattern recognition
Policy-Native AI
AI that understands insurance policy language
Intelligent Reasoning Platform
Decision-making AI with explainability
Explainable AI
Transparent AI decision-making
Audit-Ready Automation
AI with complete audit trails
Ready to Transform Your Claims Department?
See how AVI Claims can reduce handling time by 40% while improving decision accuracy.