Customer Story
Insurance provider
Claims & policy colleague handles intake, evidence checks, and customer updates—clearer communication and calmer peaks for the team.
Location
Dublin, Ireland
Industry
Insurance
19%
fewer back-and-forth contacts per case.
Dublin Insurance Provider — Claims & Policy, Streamlined
Executive summary
A national insurance provider in Dublin, Ireland implemented Cogniforce AI Workspace with a role-based Claims & Policy Colleague to triage FNOL, validate documents, prepare customer updates, and coordinate with assessors. In the first 90 days the team saw 41% less manual admin, 28% faster claim cycle time (FNOL → decision), and 19% fewer back-and-forth contacts thanks to clearer requests and proactive status messages. Agents and adjusters stayed in control; the Colleague handled the repeatable steps and escalated anything judgment-heavy.
Where they started
Growth and weather spikes pushed volumes beyond what the team could comfortably handle. FNOLs arrived via forms and email; evidence came as PDFs and photos in every format; policy wording lived across shared drives. Agents retyped data into the claims system, chased missing documents, and copied status notes into templated emails. Customers waited for updates; leaders wanted fewer handoffs and a clean audit trail.
Why Cogniforce
Three needs made Cogniforce the fit:
One source of truth. AI Workspace centralized policy wordings, endorsements, excess tables, repair partner SLAs, complaint procedures, and approved phrasing—with versioning and access control.
A time-saving colleague. The Claims & Policy Colleague drafted intake confirmations, requested exactly the right evidence per claim type, normalized documents, and prepared customer updates in the brand’s voice—always within guardrails.
Governance by design. EU-hosted processing, least-privilege access, prompt sanitization, and immutable logs satisfied internal audit and regulatory expectations.
What we implemented
Week 1 — Foundations. Connected claims platform (intake, adjudication, payments), email, secure upload, and the repair partner portal. Ingested policy wordings/endorsements and mapped top claim types (escape of water, storm, theft, motor collision).
Week 2 — Co-pilot. The Colleague proposed drafts; agents approved. We tuned tone, evidence checklists by claim type, and escalation rules (injury, high value, fraud flags, vulnerable customers).
Week 3 — Guided automation. Routine steps ran under human supervision: validate intake, collect missing details, ingest receipts/photos, pre-fill assessor briefs, propose decision letters from adjuster notes, and schedule repair partner visits within SLA windows. Anything outside policy or tone routed to a person with a one-screen summary and options.
Two light add-ons pulled extra weight:
Doc Extractor Mini. Read PDFs/photos, captured totals, dates, and line items, and highlighted confidence gaps (“amount illegible”) for review.
Status Pings. Short, plain-language updates (“assessor booked,” “awaiting invoice,” “decision ready”) that deflected “any update?” calls.
Day-to-day after launch
Morning queues arrive pre-sorted by severity and age. For a new escape-of-water claim, the Colleague confirms receipt, checks policy basics, requests precise evidence (3 photos, plumber’s report, estimate), and drafts a friendly checklist in the customer’s language preference. When documents land, Doc Extractor Mini pulls amounts/dates, flags mismatches, and prepares a tidy pack for the adjuster. If approved, the Colleague generates the decision letter with the correct endorsement citations and posts the payment note to the claims system; if not, it prepares a clear ask for what’s missing.
Team leads spend less time re-writing emails and more time tuning playbooks: for storm surges, ask for roof photos at angles A/B; for motor glass claims, default to partner X unless outside region; for vulnerable customers, use the shorter reassurance script.
Measurement approach
Before go-live, the provider sampled six weeks of time spent on intake, document chasing, and status updates; and pulled baseline cycle times by claim type. After go-live, the same measures came from system logs and periodic sampling. Weekly reviews checked tone, accuracy, and whether the latest templates and wordings were used. Any repeated edit was folded back into Workspace so everyone benefited.
Results after 90 days
41% less manual admin across in-scope tasks (intake checks, evidence requests, status updates, document normalization). 28% faster claim cycle time for standard property and motor claims due to complete first submissions and quicker assessor briefs. 19% fewer back-and-forth contacts because requests were precise and status pings kept customers informed. Complaint rates held steady while internal audit noted cleaner, more consistent case files.
See how this maps to your stack
15-minute walkthrough of the exact playbooks, guardrails, and Colleagues—tailored to your tools and policies.
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The AI Colleague that saved the most time
Claims & Policy Colleague is a careful coordinator. It validates intake details, requests the right evidence once, organizes documents, drafts updates and letters with correct clauses, and posts notes to the claims system—always with one-click human approval. When it detects risk (injury, fraud indicators, high value, vulnerable customer), it escalates with context and the approved script.
Governance & data protection
Access is role-based and least-privilege. PII is minimized and redacted from model training. Every action—checklist sent, document ingested, letter drafted—has a timestamped entry with the template version used. Processing stays in the EU; retention mirrors policy and regulatory requirements.
What changed for customers and the team
Customers get clear, calm instructions and fewer “we still need…” messages. Agents spend their energy on decisions, not document wrangling. Adjusters receive structured packs instead of long email threads. Leaders see steadier throughput during weather spikes and cleaner evidence for audits and complaints handling.
Lessons we’ll keep
Start with the top five claim types by volume; tune checklists weekly. Put the exact clause text and endorsement logic in Workspace, not in someone’s head. Keep a human gate on injury, fraud, and high-value cases—judgment is the point. Treat status pings as a product: short, predictable, and on brand.
What’s next
The team is piloting a Repair Partner Scheduler that proposes slots across preferred vendors and a Recovery Pack Builder that assembles claim summaries for reinsurers with one click—both ride on the same guardrails and knowledge already in place.
If you run claims or customer care and want faster decisions with fewer handoffs—while staying governed—book a tailored demo. We’ll walk you through the exact playbooks used here and fit them to your systems.
