Incident details stay together
Link the customer’s account of the incident and the relevant case references.
CLAIMS AUTOMATION · AI WORKFORCE
Give your claims team a complete starting point.
Intake captured, documents collected and gaps chased, so an assessor opens a referenced file rather than a blank one.
A defined business outcomeEvidence in your systemsHire or build the responsible role
WHAT BETTER LOOKS LIKE
Start with the result your team needs.
These are the intended outcomes to validate for your deployment. Judge the employee by the work completed and the exceptions handled, not by conversation volume alone.
Missing items become visible work
Maintain a checklist and follow up on outstanding information within the configured scope.
Handlers receive review-ready intake
Prepare the packet with unresolved questions clearly flagged, not a promise of claim approval.
THE EVIDENCE STANDARD
A prepared intake packet is evidence of progress, not approval.
Measure the pilot against agreed completion criteria and verify each outcome in your systems.
WHAT COMPLETION LOOKS LIKE
An intake packet ready for the claims handler.
Completion follows confirmed evidence. Each state below depends on the required source record.
Claims intake packet
Incident linked
Details saved against the correct case
Awaiting next source confirmationIncident linked
Details saved against the correct case
Shown in this exampleChecklist reconciled
Received and outstanding items distinguished
Pending evidenceReview packet prepared
Evidence and open questions sent to the review queue
Pending evidence
Intake readiness does not establish document validity, coverage or settlement approval. No live records or measured performance are shown.
| Outcome to validate | Evidence that supports it | What is not sufficient |
|---|---|---|
| Captured incident | Recorded incident details and a matched case or policy reference. | A conversation completed without a linked record. |
| Document readiness | Checklist with received and outstanding items explicitly identified. | An upload treated as validated evidence. |
| Ready for review | Saved packet, open questions and an assigned review queue. | Intake completion presented as accepted coverage or settlement. |
Compare against your own baseline.
Define review-ready intake with claims handlers before the pilot. Measure missing-information cycles, time to that state, incorrect case updates and unowned exceptions. Report claims decisions and settlement outcomes separately from intake performance.
THE WORKFLOW
See the responsibility in action.
See the employee’s actions, the record it prepares and when a person takes ownership.
AISHA AT WORK
From first notice to a review-ready claim.
Aisha autonomously captures incident details, links case records, prepares document checklists, follows up on missing items and delivers review-ready intake packets. Switch to an exception to see when, and why, your team steps in.
The conversation
My car was damaged yesterday. I need to start a claim.
AISHA
Let’s capture the incident details and check which documents your intake process needs.
Conversation → structured context
Aisha
Record incident details and identifiers
Autonomous · within your rules
Claims + documents
People join only when needed
Claim intake
- Incident · details recorded
- Policy · reference matched
- Documents · checklist prepared
SYSTEM ACTION
Record incident details and identifiers
Awaiting workflow steps
Step 1 of 4 · Capture
Example sequence only. Channels, integrations and permitted actions are configured and validated for your deployment.
PUT A ROLE BEHIND THE OUTCOME
Hire Aisha. Or build your own.
Choose a pre-built role, then configure its knowledge, supported actions and limits for your environment.
Aisha
AI Claims Intake Agent
Capture incident details, collect outstanding items and prepare a referenced intake packet.
Hire Aisha →Build a custom workforce
Design a responsibility around your outcome, systems and exception rules. Agree the evidence that will establish completion before adding channels or expanding autonomy.
Build your workforce →MAKE THE OUTCOME SUPPORTABLE
Agree the access, authority and evidence.
A credible pilot needs the right source records and clear boundaries. Review the proposed scope with the owners who will operate and assess it.
Connect the source of truth
Scope claims records, policy references, document storage and handler queues. Confirm matching, authorized access, checklist versions and the difference between receipt and validation.
Review integration requirements →Keep decisions with the right owner
Coverage questions, liability, document assessment and settlement remain with the claims team. Missing or conflicting evidence should be flagged for review, not silently resolved through inference.
Review governance & security →Bring evidence to the first discussion.
Share anonymized examples, the current outcome definition, baseline measurements and cases that went wrong. Agree the test cohort, observation window and release criteria. Keep unresolved and failed cases visible in the evaluation.
CLAIMS AUTOMATION QUESTIONS
Understand the outcome, and its limits.
What is AI claims automation?
AI claims automation is a workflow an AI employee owns from first notification through document collection and gap chasing, so an assessor opens a referenced file rather than a blank one.
Does this automate claim approval?
No. The example covers intake preparation: capturing details, linking records, following up on missing items and preparing the packet. Coverage and settlement decisions remain outside Aisha’s defined responsibility.
What does review-ready mean?
Agree a checklist with the handlers for the claim type in scope. Required details should be linked, document states explicit and unresolved questions visible. Review-ready does not mean every document is valid or the loss is covered.
Can an uploaded document be treated as verified?
Receipt and validation are different events. The role can record receipt and organize the packet, but any required document assessment needs its own authorized process and evidence.
How do we show that intake has improved?
Compare similar claim types using agreed readiness criteria and observation periods. Measure missing-item cycles, time to readiness and errors in the linked record. Avoid presenting faster intake as faster settlement without separate supporting results.
How do we measure success?
Agree a baseline and completion criteria for the workflow. Compare outcomes using your source records, including verified system changes, human review and unresolved cases.
Can we hire a pre-built employee or build our own?
Both. Start with a pre-built responsibility shown here, or design a custom role around your outcome. In either case, scope knowledge, system access, permitted actions and exception ownership before launch.
What do we need for a pilot?
Bring the target outcome, baseline records, representative requests and exceptions, required systems and an accountable owner. Agree success criteria and data-handling requirements before testing. Timing depends on access, integration and review work rather than a universal launch promise.
Which integrations and channels are supported?
Confirm the specific systems, API operations, access requirements and channels with the implementation team. The categories here are a scoping guide, not a native-integration guarantee. Test failure handling and result verification as well as successful interactions.
CUSTOMER REVIEWS ON G2
From conversations to completed work.
4.9/ 5
1 / 7
START WITH A RESULT YOU CAN VERIFY
What would a better outcome look like for your team?
Bring one responsibility and the records that define success. We’ll scope the employee and the evidence needed to evaluate it.