Where it runs
Claims teams handling high volumes of mixed-quality submissions
Claims
Why it exists
Every claim arrives in a different shape. Sorting, checking and routing is manual work that happens before any assessment starts, and simple claims wait behind complex ones.
What it does
The agent extracts the facts from the claim and its attachments, tests them against the rules, scores complexity and risk, and routes with a summary. Straightforward claims move quickly; the difficult ones reach a specialist with the work already prepared.
What changed
- Triage handled in seconds instead of an assessor's morning
- Simple claims stop queueing behind complex ones
- Assessors open a claim that is already summarised and checked
Built with
- Microsoft Copilot Studio
- Azure AI Document Intelligence
- Power Automate
- Dynamics 365