Solution
AI Document Intelligence for Insurance Claims
Turn unstructured claim bundles into validated, decision-ready data — classified, extracted, cross-checked against policy and routed into your claims workflow.
The problem
Why this process resists automation
A claim rarely arrives as one clean document. It arrives as a bundle: a form, an ID, a police report, invoices, photographs, medical notes — often scanned together into a single PDF in no particular order.
- — Mixed bundles that must be split and classified before anything can be read
- — Handwritten claim forms and physician notes
- — Invoices and estimates that must be checked against policy limits
- — Identity and coverage verification done manually at intake
- — Fraud signals spotted late, after payment authorisation
- — Turnaround time promises that depend on individual adjusters
Today
How the work happens now
- 01Claim bundle received by email, branch or portal
- 02Clerk separates the bundle and renames files
- 03Key fields typed into the claims system
- 04Policy checked in a separate screen for coverage and limits
- 05Invoices totalled and compared with the estimate by hand
- 06Adjuster reviews everything again before a decision
How PrismIQ solves it
Insurance Claims Processing with document intelligence
Bundle splitting and classification
Multi-document PDFs are separated into their constituent documents and each is classified before extraction.
Handwriting and mixed language
Printed and handwritten content is read, including English, Arabic and Urdu forms and annotations.
Cross-document reasoning
Dates, names, vehicle or patient identifiers and amounts are compared across the documents in a single claim to surface contradictions.
Policy-aware validation
Extracted amounts and event details are checked against coverage, limits, deductibles and exclusions held in your core system.
Adjuster-ready output
The adjuster receives a structured summary with confidence levels, flagged inconsistencies and links to the source region of each value.
Documents
Document types handled
Extraction
Data captured
- Claimant and policyholder identity details
- Policy and certificate numbers
- Incident date, time, location and description
- Diagnosis, procedure and treatment references
- Vehicle, property or asset identifiers
- Claimed amounts by line, provider and currency
Validation
Checks applied to every document
- Claimant identity consistent across documents in the bundle
- Incident date within the policy period
- Claimed items within coverage, sub-limits and deductibles
- Provider or garage recognised and in-network where applicable
- Duplicate invoice or duplicate claim detection
- Arithmetic consistency between estimates, invoices and claimed totals
Workflow
End-to-end processing flow
- 1Intake from email, branch scan, portal or API
- 2Split and classify the bundle
- 3Extract per document type
- 4Cross-validate across documents and against the policy
- 5Score confidence and flag inconsistencies
- 6Route: straight-through, adjuster review, or investigation
- 7Push structured data into the claims system
Integration
Where the data goes
Security
Deployment and control
Outcomes
What changes for the business
Faster intake
Claim data is structured on arrival rather than after a queue of manual keying.
Consistent assessment
The same validations run on every claim regardless of who receives it.
Earlier risk signals
Contradictions between documents surface before authorisation, not after.
Better customer experience
Shorter, more predictable turnaround on straightforward claims.
Outcomes describe the design intent of the solution. Actual results depend on document complexity, workflow design, integration requirements and deployment environment.
Frequently asked questions
Bring insurance claims processing into straight-through processing
Book an enterprise demo and we will walk through your document types, validation rules and integration architecture.