Agents for claims, underwriting and policyholder service
In short
Dynamiq gives insurers one governed platform for policyholder service, claims intake and review, underwriting file preparation and back-office work, deployed on Dynamiq Cloud or inside infrastructure you control. Voice and chat agents answer inbound calls and messages, document agents read claims and submissions against your guidelines, and an adjuster or underwriter approves every coverage, pricing and payment decision. Every run is traced and replayable, so you can show an auditor or regulator how an agent reached its recommendation.
What makes it hard
- Claims surges swamp every channel
- A storm, a flood or a busy travel season sends calls, emails and documents in at once, and adjusters end up answering status questions instead of working claims.
- Files arrive as documents, not data
- Submissions, estimates, invoices and medical reports come in as PDFs and scans that someone still has to read, re-key and check against the policy.
- Every decision is regulated
- Coverage, pricing and payment decisions need a named person, guidelines applied the same way every time, and a record an examiner can follow.
Agents we deploy
- Claims intake and reviewTakes first notice of loss by phone or chat, opens the claim, reads the documents that follow and prepares the file for an adjuster.
- Policyholder service by phone and chatAnswers policy, billing and claim-status questions on inbound calls and chat, and transfers to a person when needed, with the transcript saved in the trace.
- Underwriting submission reviewReads submissions and supporting documents, extracts the risk details and flags anything outside appetite or guidelines to an underwriter.
- Policy and guideline assistantAnswers adjuster and underwriter questions from policy wordings and guidelines, with a citation to the clause it used.
- Premium, commission and payment operationsReconciles premiums, commissions and claim payments across systems and drafts the report for approval before it is filed.
- Governance across every agentOne set of guardrails, approvals, traces and evals across claims, underwriting and service agents, instead of separate controls for each.
A tree fell on my car in last night's storm. How do I start a claim?
You're covered for storm damage. I've opened claim 58213 and booked an inspection for Thursday at 10.
Perfect, thank you.
Controls your reviewers ask for
Run on Dynamiq Cloud, or self-host in your own AWS, Azure, GCP, IBM Cloud, OpenShift or any Kubernetes 1.32+ cluster next to your policy and claims systems. Dynamiq holds SOC 2, and signs a BAA for HIPAA workloads and a DPA under GDPR. Phone lines connect over SIP from your existing carrier, and fully isolated environments are delivered with our engineers.
Visit the Trust Center- A person decides coverage and payment
- Coverage decisions, denials, pricing and payments pause for an adjuster or underwriter to approve the exact output.
- Detectors before the model
- Policyholder messages and claim documents are screened for PII and prompt injection before a model reads them, and the verdict is recorded.
- Guidelines applied the same way
- Claims and underwriting checks run against your own guidelines in a knowledge base, with the clause cited on every recommendation.
- SSO and scoped access
- SSO on Enterprise, organization roles and scoped access keys decide who can build and run agents, with private projects for claims and underwriting data.
- Full audit trail
- Every run is traced and replayable, and traces export in bulk for internal audit and regulatory exams.
Use cases
- Insurance claims processingTake first notice of loss by phone or chat, read the documents, check coverage and prepare the claim, with an adjuster deciding every payment.How it works
- Customer serviceAnswer inbound calls and chats, look up and act on the account, and hand complex cases to a person, with every conversation traced.How it works
- Contact center voice agentsAnswer your phone lines with voice agents that look up the caller's account, resolve routine calls and transfer to a person when a call needs one.How it works
- Document review and underwritingRead loan files, underwriting submissions and contracts, check them against your rules, and flag exceptions for a reviewer instead of a rubber stamp.How it works
- Back-office and finance operationsReconcile accounts, clear payment exceptions, prepare dispute cases and draft reports across the systems you already run, with approval before anything commits.How it works
- AI agent governanceScreen what reaches the model, approve what the agent does, and keep a replayable record of every run, with the same controls on every agent.How it works
Questions and answers
Can an AI agent take first notice of loss?
Yes. A voice or chat agent takes the report, verifies the policy, captures what happened and opens the claim in your claims system, then prepares the file for an adjuster.
Does the agent decide coverage or pay claims?
No. It prepares the file and recommends; coverage decisions, denials and payments are always approved by an adjuster first.
Can it help underwriters with submissions?
Yes. It reads submissions and supporting documents, extracts the risk details into your schema, checks them against your appetite and guidelines, and flags exceptions to an underwriter.
Can Dynamiq run inside our own cloud or data center?
Yes. Self-host on AWS, Azure, GCP, IBM Cloud, OpenShift or your own Kubernetes cluster, or run fully isolated with our engineers.
How is policyholder data protected?
Detectors flag PII and prompt injection before a model reads a message or document, access follows your roles, and every run is traced. Dynamiq holds SOC 2, and signs a BAA for HIPAA workloads and a DPA under GDPR. Detectors flag; they do not redact.
See an insurance agent on your data.
Talk to our team. We will show an agent built for your workflow and how it runs in your environment.