GLOSSARY - INSURANCE
What is Claims Processing?
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Quick Answer
Claims Processing is the end-to-end workflow of evaluating, investigating, and settling insurance claims. AI-powered claims processing automates FNOL intake, triage, coverage determination, damage assessment, fraud detection, and settlement calculations—reducing processing time from weeks to days while improving accuracy and consistency.
Definition
**Claims Processing** encompasses every step from First Notice of Loss through payment. AI systems handle routine claims automatically while routing complex situations to experienced adjusters with full context and recommended actions.
Key Points
- Automates FNOL data collection and validation
- Evaluates coverage and policy applicability
- Assesses damages using photos, estimates, and historical data
- Detects fraud indicators and routes to SIU
- Calculates appropriate settlement amounts
- Reduces average handling time by 40-50%