Back-office employee

A claims employee that works the file to decision-ready

It validates coverage against the policy, gathers and reads the documents and photos, assesses severity, calculates the estimate, and checks for fraud - then lays a decision-ready file in front of the adjuster, so claims move in hours, not weeks.

Northwind Insurance
Threads
Huddles
Drafts
Channels
#general
#claims
#siu-fraud
#random
Direct messages
AvaAPP
Priya Nair
# claims14 members
BIS|A</>
Message #claims
+@
>

The actual employee, working in your Slack.

Why teams trust it

Worked up. Ready to decide.

Live claims
|
Photos and estimate in
24/7
Works claims overnight, ready by morning
Human-in-the-loop
Adjusters decide and pay; it preps
Every claim
Coverage validated against the policy, not skimmed
The process

How it works

Step 1

Validates coverage

Reads the claim against the policy - coverage, limits, deductible, exclusions - and confirms what applies before anything else.

Step 2

Assesses & estimates

Reads the photos and documents, assesses severity, calculates the repair or loss estimate, and runs the fraud and red-flag checks.

Step 3

Hands a decision-ready file

Writes a clean file with coverage, estimate, and findings, and routes it to the adjuster - within authority for fast approval, or flagged where it needs judgment.

Watch it work

From open claim to decision-ready

It validates the coverage against the policy, reads the photos and documents, assesses severity, calculates the estimate, and runs the fraud checks - then writes a decision-ready file for the adjuster to approve.

Claim file - C-8842
CLAIM FILE
Claim #C-8842 - Opened today
Mark Reyes
Coverage
Auto - collision
LossRear bumper
Estimate$2,340
Fraud checkClear
Estimate
$2,340
ClaimCenter/ Claims / C-8842Open
Coverage
Deductible
Estimate
Fraud
Status
Source
Coverage
Deductible
Estimate
Fraud
Status
Integrations

Works in the tools you already use

GuidewireDuck CreekVeriskSalesforceSlack
Questions

Frequently asked

No. It works the file to decision-ready - validating coverage, assessing severity, estimating, and checking fraud - and the adjuster approves and pays. It does the heavy lifting; the claim decision and payment stay with a person.

It runs red-flag and fraud-indicator checks as part of working the file, and surfaces anything suspicious to the adjuster or SIU with the supporting detail - it never denies or clears a suspected-fraud claim on its own.

It bases the estimate on the photos, documents, and your estimating rules, and shows its work so the adjuster can verify it. Anything ambiguous or high-value is flagged for review rather than finalized.

Your claims and policy systems - Guidewire, Duck Creek - plus your fraud and estimating data, working the file the way an examiner would, scoped to your compliance requirements.

Related
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Caesar will call you right now, introduce himself, and show you exactly how this works.