Agentic claims intake with human approval
A reference design for an AI workflow that reads claim submissions, extracts and validates data, and prepares cases for adjusters.
This is a reference architecture describing how Shivacha approaches this class of system. It does not describe a specific client engagement and contains no client names or results.
Challenge
Claims teams receive emails, forms, photos and PDFs in inconsistent formats. Manual intake is slow, and fully automated decisions are neither appropriate nor desired.
Context
Applicable to insurers, warranty providers and any organisation processing document-heavy requests under audit requirements.
Approach
How we approach it
- 1
Map the workflow
Document each intake step, decision and exception with the team that performs it.
- 2
Specialised agent steps
Classification, extraction, policy lookup and completeness checks as separate, testable steps.
- 3
Confidence routing
Low-confidence fields and all decisions go to adjusters with context.
- 4
Shadow mode
Run alongside the existing process and compare before going live.
Architecture
System design
Technology
Implementation
Key implementation elements
Document AI
Extraction with source highlighting for every field.
Typed tools
Narrow, validated tools for policy and claims system access.
Review console
Side-by-side document and extracted data view.
Trace storage
Every step recorded for audit and improvement.
Outcome
The intended result is faster, more consistent intake where adjusters spend their time on judgement rather than data entry — with every AI step visible and reviewable.
Lessons
- Separate agent steps are easier to evaluate and improve than one large prompt.
- Adjusters adopt tools that show sources, not just answers.
- Shadow mode builds the evidence needed for any expansion of automation.
Services
Services involved
Agentic AI Development
Multi-agent and agentic systems that coordinate specialised agents across long-running workflows with supervision and control.
Learn moreAI Document Processing
Intelligent document processing that reads invoices, contracts, IDs and forms, extracts validated data and routes exceptions.
Learn moreAI Workflow Automation
Design and build AI-powered workflows that connect your systems, route decisions and escalate exceptions automatically.
Learn moreMore work
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