A top-5 European multi-line insurer rebuilt its first-notice-of-loss intake on xyner — auto-resolving 7 of every 10 routine claims and freeing handlers for complex cases.
A multi-line P&C insurer was handling 1.2M digital FNOL submissions and service contacts annually with a contact-centre cost of $48/contact and average handle time of 18 minutes. Customer effort scores were declining; agent attrition was running at 32%.
Deployed an FNOL Triage Agent, Coverage Verification Agent and Customer Comms Agent on xyner with full integration to Guidewire, the policy admin system, fraud-scoring service and the claims workforce-management platform.
60% of digital traffic now handled end-to-end by agents; AHT down 40% on agent-handled work; CSAT lift of +15 points; agent attrition halved as routine work moved off human queues.
A multi-line property & casualty insurer in North America
Digital first-notice-of-loss (FNOL) and claims service
From contract signature to full rollout.
The deployment runs in the insurer's AWS US-East VPC as a single-tenant data plane, with policy-aware RAG pointing at the policy-document repository and HIPAA-aligned handling for any health-related claims.
Parses incoming FNOL across web, app and contact-centre channels; classifies by claim type, complexity and urgency; pulls policy and historical context.
Validates coverage against policy clauses with citations; identifies exclusions and conditions; surfaces any prior-claims patterns relevant to the new claim.
Calls the existing fraud-scoring service; agents handle low-score claims autonomously and route high-score claims to SIU with full reasoning trace.
Drafts and dispatches customer comms — acknowledgement, requests for additional info, status updates — in the customer's preferred channel and language.
When human handling is required, agents brief the human handler fully — no asking the customer the same question twice.
For claims requiring field adjusters, agents dispatch through the existing WFM system based on geography, specialty and SLA tier.
An 8-week pilot covered motor claims in three US states before expanding to all motor and then to home, with specialty lines following in the second half of the year.
Deploy in AWS US-East; integrate Guidewire, policy admin, fraud-scoring, WFM; establish RBAC inheritance from the insurer's IdP.
Configure the three agents against the insurer's existing claims playbooks; load policy documents into policy-aware RAG; complete bias and explainability testing.
Agents run alongside human handlers in three pilot states; outputs reconciled daily; thresholds calibrated.
Live in three states for motor FNOL with human handling above complexity threshold; metrics monitored continuously.
Roll out across all motor claims nationally with state-specific compliance variations.
Extend to homeowners and selected specialty lines; CSAT and AHT measured weekly.
P&C insurance is increasingly under sectoral AI scrutiny — NAIC Model Bulletin, Colorado regulation, emerging state-level requirements.
Underwriting and triage decisions are continuously tested for disparate impact across protected attributes; results reviewed quarterly by Chief Actuary and General Counsel.
Every coverage decision includes a citation chain — the policy clause, the precedent claims, the inputs. Customers and regulators can see exactly why the decision was made.
The deployment is aligned to the NAIC AI Bulletin requirements for governance, risk management and consumer protection.
Claim payouts above defined thresholds (varies by line of business) require human approval; complex or sensitive claims always route to humans.
Agents never pressure customers, never withhold material information, and always offer a clear path to a human handler.
Three lessons that other insurers should take from this deployment.
Customer effort goes down when agents actually resolve the case end-to-end — not when chatbots stall the customer. The insurer measured deflection by resolution, not by 'did the customer not call'.
The biggest single experience win was eliminating 'tell me your problem again' moments. Hand-off briefings are a first-class workflow primitive, not an afterthought.
Confidence and risk thresholds drift as the agent learns and as the population shifts. The insurer's ops team reviews and recalibrates thresholds monthly.
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