AI Claims Agent

A claims agent that triages,
extracts, and remembers.

Automate FNOL intake and lifecycle follow-up across voice, email, and SMS. Extract evidence from any source, flag missing documents, reconcile records, and carry full memory of the claim from first notice to closure.

< 15s avg queue time
63% AI-resolved FNOL
96%+ first-capture accuracy
app.infinitewatch.ai/solutions/claims-agent/workflow

Claims workflow

Read-only view of the canonical claims worker pipeline.

Language · EN ▾
+ New step

Visual workflow map

Receive → triage → extract → reconcile → follow up

Receive claim

VOICE · EMAIL · SMS

Intake

Inbound channel arrives in the configured claims inbox.

Store inbound event

TRACEABILITY

Traceability

Audio, message, attachments and conversation context persisted for replies.

Detect existing case

CASE CONTINUITY

Case continuity

Match against open claims or start a new request · memory across the lifecycle.

Analyze with InfiniteWatch AI Agent

INFINITEWATCH AI AGENT

InfiniteWatch AI Agent

Detect claim intent, extract policyholder ID, incident facts and evidence references.

Is this a claim?

CLASSIFICATION

Classification

If it does not look like a claim, route it for manual review.

No
Yes

Route non-claim

EXCEPTION

Exception

Email does not look like a claim · left for human review with full context.

Extract evidence & look up customer

CRM · DOCUMENT AI

CRM

Pull 40+ structured fields from text, audio, photos, and PDFs. Match policyholder by DNI.

Reconcile records & flag missing docs

QUALITY GATE

Reconciliation

Compare against policy data; surface missing photos, IDs, or third-party reports before adjuster handoff.

Follow up & remember

LIFECYCLE MEMORY

Memory

Voice, email or SMS nudges with full case memory. Hand off warm to a human only when needed.

Trusted by claims and operations teams worldwide

Job&Talent
Northius
Carto
The Guarantors
Mito
Job&Talent
Northius
Carto
The Guarantors
Mito
THE CHALLENGE

Claims intake is broken in the moments that matter most

Insurers handle structured, high-volume work with tools built for ad-hoc human routing.

FNOL Queues That Collapse Under Spikes

A storm event or fender-bender Monday drives wait times from minutes to hours. Customers abandon, claims get lost, and adjusters burn out triaging the chaos.

Email & SMS Claims in a Black Box

Inbound emails sit in shared inboxes for hours before anyone reads them. Photos and PDFs attached to a claim never make it into the claims system on first try.

18%+ First-Capture Rework

Missing fields, wrong policy numbers, blurred photos · every gap forces a follow-up call. The adjuster pays the cost of every intake mistake.

Evidence Scattered Across Channels

Voice notes here, an email with damage photos there, an SMS with a police report number · no one assembles the full picture without manual hunting.

Slow, Inconsistent Follow-Up

Adjusters chase missing documents on personal email threads. Each claim has its own cadence, and the customer never knows what's pending.

No Memory Between Touchpoints

Every call starts from zero. The customer re-explains the loss. The adjuster re-reads the file. Continuity is human-powered, and it's expensive.

CAPABILITIES

Four jobs your claims agent does, end to end

Not a chatbot bolted onto a phone line. A true claims worker that owns the case from first notice to handoff.

Triage and follow-up by voice, email, and SMS

Answers every FNOL call in seconds, reads every claims email on arrival, and runs proactive SMS follow-ups. One agent, all channels, with consistent tone and compliance guardrails.

  • Sub-15s avg queue time on voice intake
  • Email parsed and triaged on arrival, 24/7
  • Outbound SMS nudges with full case context

Evidence extraction from any source

Pulls structured claim data from natural-language descriptions, audio, PDFs, photos of damage, police reports, and medical records · mapped to the same 40+ field schema across every channel.

  • Document AI for photos, PDFs, and scans
  • Speech-to-structured-data on voice intake
  • Unified schema across voice and email

Flags missing documents; reconciles records

Cross-references every field against the policy record in real time. Surfaces gaps · missing IDs, damage photos, third-party details · before the claim is handed to an adjuster.

  • Real-time validation against policy data
  • Missing-document alerts before adjuster handoff
  • First-capture accuracy from 82% → 96%+

Memory across the entire claim lifecycle

Every voice call, email, SMS, and document is linked to the case. The agent knows what was said, what's still open, and what was promised · across every touchpoint, from FNOL to closure.

  • Case continuity detection on every inbound event
  • Warm transfer with structured FNOL + audio + sentiment
  • 100% post-interaction analytics, never sampled
OUTCOMES

Measurable claims impact from day one

Results from a mid-size P&C insurer handling 38,000 inbound claims calls per month with InfiniteWatch.

63%

AI-Resolved FNOL

Of inbound claims calls completed end-to-end by the agent · no human transfer required. Adjusters only see what genuinely needs them.

< 15s

Avg Queue Time

Down from 4+ minutes. Every call answered in seconds, including during severe-weather spikes that used to push waits to hours.

96%+

First-Capture Accuracy

Rework rate drops from 18% to under 4%. The 40+ structured fields are validated against the policy record during capture, not after.

Elastic Spike Handling

Handles three times peak volume without queue buildup. 10,000+ simultaneous voice lines available on demand.

24/7

Voice + Email + SMS

Always-on intake across every channel. Email and SMS get the same structured extraction and lifecycle memory as voice.

100%

Post-Interaction Analytics

Every call, email, and SMS transcribed, scored for compliance and completeness, and surfaced in real time · no more manual sampling.

BEFORE vs. AFTER

What changes the day the agent goes live

DimensionBefore (Human Intake)With InfiniteWatch AI
Average queue time4+ minutesUnder 15 seconds
FNOL data completeness82% (18% rework)96%+ at first capture
Weather event capacityFixed, waits multiplyElastic, absorbs any spike
Intake channelsInbound phone, business hoursPhone + email + SMS, 24/7
Email document processingManual triage, hours of delayDocument AI extracts on arrival
Adjuster context at transferVerbal summary onlyStructured FNOL + audio + sentiment
Post-call analyticsManual samplingReal-time, 100% coverage
Simultaneous capacityLimited by headcount10,000+ lines
HOW IT WORKS

From systems connected to FNOL handled in days

Built for claims operations, not engineering teams.

01

Connect Channels & Systems

Plug in your claims inbox, voice line, SMS gateway, and policy / CRM system. Pre-built connectors mean no custom engineering.

02

Map Your Claims Workflow

Configure intake, classification, evidence extraction, missing-document rules, and escalation paths in a visual workflow editor.

03

Go Live in Shadow Mode

Run the agent silently alongside your team first. Validate behavior on real claims, tune prompts, then promote to production with one click.

04

Monitor, Score, Optimize

Track AI-resolution rate, first-capture accuracy, escalation reasons, and compliance flags in real time. Every interaction is scored automatically.

TESTIMONIALS

What people are saying

Within 24 hours of deployment, we had 10x more visibility into critical conversion blockers that were costing us revenue every single day.

AG

Aitor Gumiel

VP of Product @ TheGuarantors

InfiniteWatch showed us what the customer was doing on our platform before they called. We can see the previous web sessions, and then hear the call. Our agents now resolve issues 40% faster because they understand the full story.

AB

Alberto Baselga

CPO/CIO @ Northius

InfiniteWatch caught a third-party integration bug that was silently killing our top-of-funnel conversion and helped us deep dive into the root cause.

AF

Angela Fernández

Product @ Remotely.works

Turn your claims intake
into an always-on engine.

See the Claims Agent run against a sample workflow · voice, email, and SMS · and get a tailored estimate of the resolution lift on your own claim volume.