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A low shelf cloud over a dark plain strewn with thousands of white hailstones. Hail is still falling on the right, and a thin band of coral light lies along the horizon where the storm clears.

Insurance claims

The claims fleet.

Our agents handle every claim from first notice of loss to a file ready to pay, inside your claims system. When a hailstorm brings forty thousand claims, the fleet adds agents within the hour.

Storm

  1. A calm month

    Six thousand claims a month, and your claims desk keeps pace.

  2. Tuesday 14 May, 16:40

    Hail across the city. Forty thousand claims by Friday.

  3. Tuesday 17:30

    Within the hour the fleet adds 140 agents.

  4. Wednesday

    The lanes reorder: uninhabitable homes first, then total losses. Glass moves to overnight batches.

  5. Thursday 16 May

    You see a date for each lane instead of a count of open claims.

Clear by

  1. Habitable property 16 May
  2. Total loss 21 May
  3. Property repair 4 June
  4. Motor repair 30 May
  5. Liability 7 June
  6. Glass Overnight batch 24 May

The dates move as claims arrive and close.

How the desk reorders
  • Priority is code your claims leadership owns: displaced households first, then total losses, then repairs by age.
  • Recovery, fraud and litigation run as lanes beside the claim classes and reorder with them.
  • Glass moves to overnight batches, which keeps the day's agents on homes and total losses.
  • When a lane drifts toward its date, the supervisor agent moves agents across before the date slips.
  • The fleet scales back as the lanes clear. Nothing waits for a staffing decision in either direction.

Settlement-ready

Every claim file is built in your claims system, layer by layer.

The policyholder hears back within minutes in the channel they wrote from. When the offer is accepted, the payment goes out and reconciles to the settlement.

A hailstone cut in half, its cut face showing rings of clear and milky ice around a white core. A thin rim of coral light catches the outermost ring.
  1. First notice
  2. Policy matched
  3. Photos read
  4. Inspection booked
  5. Estimate
  6. Valuation
  7. Reserve
  8. Settlement-ready
What the file holds
  • Coverage terms from policy administration, matched to the claimant within minutes of first notice.
  • Photos, telematics and the policyholder's account read for the loss facts. Missing documents are requested by message.
  • Field inspections booked with your repair network. Estimates pulled from CCC, Xactimate or Audatex.
  • The valuation checked against the total-loss threshold of the vehicle's state.
  • Reserves set within the authority your rules grant. Payments reconciled to the settlement record.
  • A recovery file opened wherever another party is liable, with the demand package drafted.
  • Regulatory filings and reinsurance loss notices drafted against each jurisdiction's deadline.
  • Status updates at every milestone, so the policyholder never has to chase.

Judgment

Your claims rules run as code your team can read.

  1. A claim goes to your fraud unit only when two indicators agree.

    if claim.indicators.agreeing() >= 2:
    refer(claim, to="siu")

  2. Once a lawyer is on the file, the fleet writes only to counsel.

    if claimant.represented:
    forbid(contact, claimant)

  3. A repair estimate that reaches the state's threshold sends the car to the total-loss lane.

    if repair_cost >= threshold(state) * acv:
    route(claim, lane="total-loss")

Adjusters can open, rerun or correct any file. Each correction becomes a rule, replayed on last quarter's claims before it ships.

More of the claims manual

claims/rules.py

if claim.has_open(FraudHold):
    forbid(release_reserve, claim)

if not liability.decided(claim):
    forbid(draft_settlement, claim)

waiver_limit = Rule("claims.waiver_limit", by="state")  # versioned
  • A recorded statement is never altered. No payment leaves without a reconciled settlement record.
  • A loss type the rules have not seen follows a provisional rule your claims leadership owns, and every agent picks up the update on its next claim.
  • Each release lists the claims from last quarter it would have decided differently, and your team can open any of them.

Architecture

  1. Operating Code

    Coverage, authority, fraud and total-loss rules as tested code.

  2. Gate

    Each agent has its own identity. Revoke its access and the next call fails.

  3. Your infrastructure

    Your data centre or Marbell Cloud in Switzerland. Claims data stays under your keys.

  4. Fleet

    Lanes by claim class. In a storm the fleet adds agents within the hour.

For your engineers
  • Operating Code is your claims manual rewritten as code. A coverage check becomes an if, a lane's work a while loop, a claim's history typed variables and a settlement standard a test. It grew out of the recursive self-improvement harness our own persistent agents run on.
  • A rule ships when the full suite passes on past claims, at the speed the tests run. Your team can rerun any claim under any release.
  • Agents write only through released functions. Each action reaches Guidewire ClaimCenter, Duck Creek or Sapiens under the agent's own identity, and your claims system's own authorization still applies.
  • Personal data is removed before a request reaches a model, and model calls run with zero data retention.
  • Every job carries a key built from the claim number and its document checksums, so a restarted agent never pays twice.
  • From claim to claim the fleet keeps what your desk taught it: corrections, adjuster preferences and each jurisdiction's quirks.
  • We run the same supervisor on our own research fleet, where it opens and closes agent slots around the clock.

Systems

  • Guidewire ClaimCenter Claims system
  • Duck Creek Claims Claims system
  • Sapiens Claims system
  • CCC Motor estimates and valuation
  • Xactimate Property estimates
  • ISO ClaimSearch Fraud database

Each action reaches your claims system under the agent's own identity, checked by your own authorization.

All systems
  • Your claims system and policy administration
  • CRM, email and the policyholder portal
  • Document stores, photo and telematics feeds
  • Estimatics and valuation: CCC, Xactimate, Audatex
  • Industry fraud databases such as ISO ClaimSearch
  • Repair network and inspection portals
  • Payment systems and the data warehouse
  • Court, regulatory e-filing and reinsurance reporting

Underwriting submissions are the next lane on the same fleet.

The same dark plain after the storm under a clear evening sky, coral along the horizon. In the foreground the last hailstones melt into beads of water.

The pilot replays your last storm.

We run its claims through the fleet and show you the date each lane would have cleared. Then a claim class runs live for a quarter, paid against cycle time, settlement-ready files or adjuster hours returned.

Describe your claims desk How we work