FNOL & intake
First notice of loss captured with complete documentation.
End-to-end claims processing — intake, adjudication support, payment calculation and closure — with AI-assisted triage, document extraction and fraud signal detection.
Claims processing is where insurance operations either hold up under volume or collapse into backlogs. Intake, triage, adjudication support, payment calculation, closure — each step has to be handled with speed and documentation that stands up to regulatory review.
Opervics runs claims processing as a managed function. AI-assisted triage and document extraction speed up processing; trained claims specialists handle coverage decisions and exceptions; fraud signal detection flags anomalies before payout.
First notice of loss captured with complete documentation.
Structured data pulled from claims documentation.
Coverage review and adjudication prepared for specialist approval.
Payment amounts calculated against policy terms.
Anomalies flagged for specialist review before payout.
Volume, cycle time, accuracy and anomaly trends.
These are the same operational issues we see across clients — and the same ones our process is designed to remove.
Claim volume spikes and everything slows down.
Claims sit in queues longer than they should.
Similar claims decided differently by different adjusters.
Anomalies not caught before payout.
Audit trails incomplete for regulatory review.
Nobody can see cycle time, accuracy or fraud trends.
Every service inherits the same baseline security posture, then adds service-specific controls on top.
State regulations, PII handling and audit trails built into every workflow.
NDA-bound staff, role-based access, and auditable access logs.
AI output is reviewed by trained specialists before payouts.
Cycle time, accuracy and fraud trends reported weekly.
Property and casualty, auto, specialty lines, and other claim types — with line-specific workflows defined in the scope.
We prepare adjudication for specialist review. Final coverage decisions remain with your licensed adjusters.
AI-assisted pattern analysis flags anomalies for specialist review. AI never makes a fraud determination on its own.
Guidewire, Duck Creek, Applied Epic and other claims platforms — with role-based access set by you.
Cycle time, accuracy, backlog and fraud signal trends — reported weekly with QA sampling.
Per claim, per FTE, or as a monthly retainer — agreed upfront.
A short conversation is usually enough to scope the process and propose a starting point.