Claims automation that takes your cycle time from 18 days to 5 — without replacing your core system
Regure handles the entire claims lifecycle: automated FNOL intake, AI document classification, intelligent claim assignment, multi-level approval workflows, SLA monitoring, and settlement processing. It layers on top of Guidewire, Duck Creek, or whatever you run today.
Your claims process has too many manual steps between FNOL and settlement
A typical insurance claim touches 6-8 people across 3-4 systems before settlement. The adjuster receives the FNOL, searches for the policy, requests missing documents, waits for medical records, routes the claim for approval, chases the supervisor for sign-off, generates the settlement letter, and sends it for signature. Each handoff adds hours or days.
The problem isn't that any single step is slow — it's that the gaps between steps create compounding delays. A document arrives by email but nobody classifies it for 24 hours. An approval request sits in a supervisor's inbox for 2 days because they didn't see it. A settlement letter requires three rounds of back-and-forth because the wrong template was used.
Regure automates the transitions between steps: documents are classified the moment they arrive, claims route to the right adjuster based on workload and expertise, approvals queue automatically with SLA-driven escalation, and settlement documents generate from pre-approved templates. The human judgment stays — the administrative friction disappears.
This is claims management software that reduces cycle time by eliminating the waiting, not by cutting corners on assessment quality.
Multi-channel FNOL intake that creates claim records in under 3 minutes
First Notice of Loss arrives through every channel: email, web portal, phone, broker API, field adjuster mobile app. Regure ingests from all sources, classifies the loss type, estimates severity, and assigns the claim — before a human touches it.
FNOL is where cycle time starts — and where most carriers lose the first 24-48 hours. A policyholder calls the 1-800 number at 2pm. The call center creates a record in the claims system. But the supporting documents — the police report emailed to the general inbox, the photos texted to the adjuster's personal phone, the repair estimate faxed to the branch office — don't get linked to the claim for another day.
Regure monitors all intake channels simultaneously. When a document arrives — by email, upload, fax, or API — the system identifies whether it belongs to an existing claim or represents a new FNOL. For new claims, it creates the record, classifies the loss type (auto collision, property water damage, liability slip-and-fall, health surgical authorization), estimates severity from the narrative and loss amount, and assigns priority based on policyholder status and regulatory SLA requirements.
For existing claims, incoming documents are classified and attached to the correct claim file automatically. The adjuster doesn't search for documents — documents find the claim.
- Email monitoring: Documents emailed to claims@, FNOL@, or forwarded by brokers are ingested and classified automatically
- Web portal: Policyholder and broker FNOL submissions captured with structured data and attachments
- Phone integration: Call center transcriptions parsed for claim details and routed to the claims system
- API intake: Broker management systems and aggregators submit FNOL via REST API with real-time acknowledgment
- Mobile app: Field adjusters photograph damage, record notes, and submit directly from investigation sites
- Fax digitization: Incoming faxes converted to searchable PDF, classified, and routed like any other document
Intelligent claim routing based on type, severity, adjuster expertise, and workload
Not all claims need the same handling. A $3K fender-bender doesn't require a senior adjuster. A $500K commercial property loss shouldn't go to a junior. Regure routes every claim to the right person based on configurable rules.
Rule-Based Routing
Configure assignment rules per line of business: auto claims under $10K route to Tier 1 adjusters. Property claims over $100K route to senior property specialists. Health claims involving surgical authorization route to medical review. Workers comp claims in specific states route to adjusters licensed in those jurisdictions.
Rules evaluate claim attributes at intake — loss type, estimated amount, geographic location, coverage type, policyholder tier — and route to the appropriate handler or team queue. No manual triage required.
Workload Balancing
Assignment considers each adjuster's current caseload, SLA performance, and availability. An adjuster with 45 open claims and declining SLA metrics doesn't receive new assignments until their queue normalizes. An adjuster returning from vacation gets a gradual ramp-up, not a full queue dump.
For TPAs handling multiple carrier clients, workload balancing operates within carrier boundaries — adjusters assigned to Carrier A don't receive Carrier B's overflow.
Expertise Matching
Complex claims require specialized knowledge. Regure tracks adjuster certifications, training completions, and claim type experience. A construction defect claim routes to adjusters with construction experience. A marine cargo claim routes to adjusters with marine certification. A cyber liability claim routes to the technology E&O specialist.
Expertise matching reduces assessment errors and rework — the right adjuster gets the claim from the start, not after a reassignment.
CAT Event Surge Handling
When a catastrophe event generates 5-10x normal FNOL volume, standard assignment rules won't work. Regure's CAT mode redistributes claims across all available adjusters, activates temporary assignment pools for independent adjusters and contractors, and raises settlement authority limits for faster resolution.
CAT assignment rules are pre-configured and activate when FNOL volume exceeds defined thresholds — no manual intervention required during crisis response.
Multi-level approval chains with settlement thresholds and delegation
Settlement authority limits are fundamental to claims governance — but they create bottlenecks when approvals happen via email. Regure automates the entire approval chain with SLA tracking and delegation.
Most carriers operate tiered settlement authority: junior adjusters approve up to $10K, senior adjusters up to $50K, supervisors up to $250K, claims directors above that. These controls manage risk — but when approvals happen through email, they create 2-3 day delays for decisions that take 10 minutes.
Regure automates approval routing based on settlement amount and claim characteristics. When an adjuster recommends a $75K settlement, the system routes to the appropriate approver with complete claim context: adjuster's recommendation, supporting documentation, loss history, and reserve analysis. The approver reviews and decides in-app — no email chain, no context switching.
When approvers are unavailable, delegation workflows ensure claims don't stall. Supervisors designate alternates who receive approval requests during absences. Temporary authority increases during CAT events allow adjusters to approve higher amounts without individual authority changes. Every approval decision is logged in immutable audit trails with timestamps, decision rationale, and approver identity.
- Configurable authority tiers per role, line of business, and claim type
- One-click approve/deny with mandatory decision notes for amounts above threshold
- Auto-escalation when approvals exceed SLA (default: 24 hours for routine, 4 hours for urgent)
- Delegation workflows for supervisor absence — claims never stall waiting for a single person
- Batch approval mode for high-volume, low-complexity claims during CAT events
- Complete audit trail: who approved what, when, with what rationale
Fraud indicators flagged at intake — before investigation resources are wasted
Insurance fraud costs the industry $80B+ annually. Regure detects fraud indicators at FNOL intake — duplicate claims, suspicious patterns, known fraud addresses — and routes flagged claims to your SIU automatically.
Duplicate Claim Detection
The same loss reported under different policy numbers, to different adjusters, or by different claimants. Regure compares incoming FNOLs against active and historical claims — matching on claimant names, loss dates, loss locations, vehicle VINs, and property addresses. Potential duplicates flag for SIU review before an adjuster begins investigation.
Cross-reference detection extends to related parties: same household members, same address, same employer, same attorney representation — patterns that indicate organized fraud rings.
Pattern Recognition
Fraud doesn't always look like a single suspicious claim — it looks like patterns across many claims. Multiple claims filed within short timeframes, claims filed immediately before policy cancellation, unusually high claim amounts relative to policy limits, and providers with statistically anomalous claim frequencies.
AI models trained on claims data identify patterns indicating opportunistic fraud (individual claimants inflating legitimate losses) and organized fraud (rings operating across multiple policies and carriers).
SIU Routing & Evidence Packaging
When fraud indicators are detected, the claim routes to your Special Investigations Unit with a complete evidence package: the fraud indicators that triggered the flag, related claims and claimants, timeline analysis, and supporting documentation. SIU investigators start with context, not a blank file.
For carriers without dedicated SIU teams, fraud-flagged claims route to senior adjusters with enhanced investigation checklists and documentation requirements.
Automated settlement processing with template generation and e-signature integration
The last mile of claims processing — settlement documentation, signature collection, and payment authorization — shouldn't add another week to cycle time. Regure automates settlement from approval to closure.
Settlement Document Generation
Once a settlement is approved, Regure generates the settlement letter, release form, and payment authorization from pre-approved templates — populated with claim-specific data (claimant name, loss details, settlement amount, payment instructions). No manual document assembly, no wrong-template errors.
Templates are configured per carrier, per line of business, and per jurisdiction — ensuring the correct legal language and regulatory disclosures appear automatically.
E-Signature Collection
Settlement releases require claimant signatures. Regure's integrated e-signature capability sends settlement documents for signature via email or SMS, tracks signature status in real time, and attaches the signed, timestamped document to the claim file upon completion.
Multi-party signatures — where both claimant and carrier representative must sign — are coordinated automatically with signing order enforcement.
Payment Authorization
Once settlement documents are signed, payment authorization workflows trigger automatically. Payment details route to your finance team or accounting system via API integration. Payment status updates flow back to the claim file, providing end-to-end visibility from settlement approval to check issuance or wire transfer.
For carriers using third-party payment platforms, Regure integrates via API to authorize payments without manual re-entry of settlement details.
Claim Closure & Archival
When settlement is complete — documents signed, payment issued, claimant acknowledged — the claim closes automatically. All claim documents, communications, audit logs, and workflow history are archived per your retention policies. The complete claim file is available for future reference, regulatory inquiry, or litigation support.
Reopening a closed claim triggers a new workflow with full audit trail continuity — every action on the reopened claim links to the original claim history.
What operations leaders ask about claims automation
Does Regure replace our core claims system?
No. Regure layers on top of Guidewire ClaimCenter, Duck Creek Claims, Sapiens, or whatever core system you run. It handles the document processing, workflow orchestration, and collaboration layers that core systems don't do well — while syncing claim data bi-directionally via API. See why Regure complements your stack.
How does AI document classification work?
Regure's classification engine analyzes document structure, content, and metadata to identify document types (police report, medical record, repair estimate, settlement letter) with 99%+ accuracy. Key fields are extracted (claimant name, policy number, loss date, amounts) and mapped to structured claim data. See document processing details.
Can we configure different workflows for different lines of business?
Yes. Each line of business (auto, property, health, casualty, workers comp) gets its own workflow configuration with unique SLAs, approval thresholds, document requirements, and routing rules. A single Regure instance handles multiple lines with completely separate operational logic. See workflow engine details.
What happens during catastrophe events?
Regure's CAT mode activates when FNOL volume exceeds configured thresholds. Assignment rules redistribute claims across all available adjusters, temporary pools activate for independent adjusters, settlement authority limits increase for faster resolution, and infrastructure auto-scales to handle 5-10x normal volume.
How fast is implementation?
Standard implementation is 14 days for single-line operations. Multi-line carriers typically require 3-4 weeks including workflow configuration per line, core system integration, and team training. You can start with one line of business and expand without re-implementation. See implementation process.
What does this cost?
Regure is priced per user per month. Claims automation features are included in Professional tier ($150/user/month) and Enterprise tier ($225/user/month). A carrier with 100 claims staff would typically invest $15K-22.5K/month — against cycle time savings that reduce claims leakage by $25-50M annually. See full pricing.
See Regure automate your actual claims workflow
Book a 20-minute demo with your real claim types. We'll show you FNOL intake, smart assignment, approval workflows, and settlement processing — configured for your lines of business.