Use case · Insurance & Claims
Automation for agencies, TPAs, and claims teams.
Insurance operations is paperwork in a thousand formats — ACORD forms, carrier portals, loss runs, certificates of insurance, claim docs. We build automation that pulls structured data out of every format and routes it through your AMS, claims system, and carrier integrations.
Tell-tale signs
Independent agencies and claims shops feel these the same way.
Insurance ops is one of the few B2B verticals where automation gains are still wide open:
Quoting is a multi-day process
Submit to 5 carriers, wait for responses, normalize the quotes into something comparable, present to the client. Two days minimum, sometimes a week.
Certificates of insurance are a never-ending side job
A CSR spends half their day generating COIs, fielding amendment requests, and managing certificate holders. Each one is 5 minutes of clicks.
Claims status checks live in carrier portals
Adjusters log into 8 different portals every morning to check claim status. Two more for medical bill review. Multiply by claim volume.
Renewals are a Q4 fire drill
Every policy renews on its anniversary. November–December your team is drowning in renewal quotes, loss run pulls, and comparison memos.
Highest-ROI automations
What we ship most often for insurance teams.
Built around your AMS (Applied, Vertafore, EZLynx) and your claims platform. Compliance-aware where state regulations require.
Application intake + carrier submission
Client application data captured once → normalized into ACORD format → submitted to multiple carrier portals via API or RPA → responses pulled and compared. From 2 days to 2 hours.
See related automationsCertificate of insurance automation
Self-service COI portal for clients → templated generation with auto-fill from AMS → amendment requests routed to CSR for approval. Often handles 60–70% of COI requests without human touch.
See related automationsClaims intake + triage
FNOL via web/phone/email → structured intake → severity classification → adjuster routing → automated acknowledgment to insured. Reduces time-to-first-touch from hours to minutes.
See related automationsLoss run + carrier portal monitoring
Automated polling of carrier portals for claim status updates, loss runs, and renewal info. Pushes into your AMS so adjusters and producers see current data without logging in.
See related automationsRenewal workflow automation
60-day-out renewal trigger → loss run pull → carrier shopping → comparison memo generation → producer review → client presentation prep. Spreads Q4 across the year.
See related automationsDocument classification + extraction
AI-powered document intake — ACORD forms, declarations pages, loss runs, medical bills — extracts structured data, validates, and pushes into AMS. Cuts manual data entry dramatically.
See related automationsTypical stack
The tools we usually see in this industry.
We integrate around what you run today — no platform swaps required. Don't see your tool? Ask.
- Applied Epic
- Vertafore AMS360
- EZLynx
- HawkSoft
- QQ Solutions
- AgencyZoom
- QuickBooks
- DocuSign
- Microsoft 365
- RingCentral
- Slack
- Zywave
- ID Federation
- SmartCOMM
- Salesforce Financial Services Cloud
Composite example
Mid-size commercial agency — quoting cycle cut from 2 days to 90 minutes.
The setup
Independent commercial insurance agency, $40M in premium. 8 producers, 12 CSRs. Quoting cycle averaged 2 business days end-to-end. CSRs spent ~40% of their week on COI work alone. Renewal season (Oct–Jan) required temp-staffing every year.
What we did
- 1Audited the quote-to-bind workflow with producers + CSRs
- 2Built ACORD intake form with auto-population from existing AMS records
- 3Integrated with top 5 carrier APIs for direct submission + response retrieval
- 4Built RPA fallbacks for 3 carriers without modern APIs
- 5Layered a self-service COI portal on top of the AMS for client-driven certificate generation
Composite of patterns we've seen in insurance engagements; not a single named client.
Outcome
- Quote cycle time
- 2 days → 90 min
- COI requests self-served
- 68%
- Producer time on quoting
- −42%
- Renewal season temp hires
- 0
Pricing snapshot
$15,000 – $60,000
Payback: 90–180 days typical
Most agencies start with quoting + COI automation as one project ($18k–$30k). Claims workflows and document AI usually come in phase 2.
- Free 30-min scoping call
- Industry-specific scope
- Source code + workflows you own
- 30 days post-launch tuning
- Compliance-aware where relevant
Questions
Common questions for insurance & claims.
- Will this work with our AMS (Applied, Vertafore, EZLynx)?
- Yes. Applied Epic has the most robust API; Vertafore AMS360 has solid endpoints; EZLynx has a developer toolkit. We've integrated with all three plus a handful of smaller AMS platforms. The pattern is the same — your AMS stays the source of truth and we extend it.
- What about state regulations and licensing requirements?
- We design workflows with state-by-state policy configuration in mind. Anything that touches a licensed producer's name or signature stays in human-review queues. Compliance is your compliance officer's call; we make sure the implementation supports it.
- Can you handle E&O / claims management for a TPA?
- Yes — TPA operations is a great fit for automation. FNOL intake, adjuster assignment, status tracking, demand handling, and reserve setting are all workflow-heavy and benefit substantially from orchestration.
- We're a captive agency — does this still work?
- Captive agencies have a simpler problem (one carrier) but the operational pain is similar. The carrier integrations become tighter, the workflow surface is smaller, and the automation is usually cheaper to build.
Other industries we serve
Different industry? Same patterns.
Ready to scope a build for insurance & claims?
Book a free 30-minute discovery call. We'll talk through your stack, your goals, and walk away with a written plan and a quote.