Insurance carriers and MGAs need to streamline claims operations while delivering better policyholder experiences. Internet Solutions for Insurance (ISi) supports automating insurance claims, which can reduce processing times and human errors. Intelligent automation (IA) streamlines the claim review process while artificial intelligence (AI) reviews images. Automated insurance claims processes help reduce delays, improve operational accuracy, and create a better policyholder experience.
Through a highly flexible database-driven architecture, seamless third-party vendor integrations, and built-in task orchestration, ISi transforms traditional, manual claim handling into a highly efficient, digital workflow. By leveraging these capabilities, insurance carriers and Managing General Agents (MGAs) can lower their operational expenses and deliver a superior experience to their policyholders.
The Foundation: First Notice of Loss (FNOL) and Core Automation
The automation of an insurance claim within the ISi system begins the moment an incident is reported. This is known as the First Notice of Loss (FNOL).
Rather than requiring an adjuster to manually search for policy limits and verify dates, ISi immediately connects the claim to the underlying policy database. The system automatically:
cross-references the entered accident date against the policy's history.
retrieves the applicable declarations page to verify coverage at the time of loss.
Once the basic occurrence is created in the master table, ISi:
collects information about the people, vehicles, and properties related to the loss.
organizes the claim into individual "features” – unique combinations of a claimant, a coverage, and a damaged item.
When an adjuster opens a feature, ISi automatically pulls the relevant limits and deductibles directly from the declarations page, preventing manual data-entry errors.
ISi can also be programmed to automatically generate default case reserves for newly opened features. Some clients also employ factor reserve setting to entirely bypass manual estimation.
Artificial Intelligence and Machine Learning Integration
While IA streamlines the structural claim review process, AI reviews images and complex unstructured data. ISi features core, bidirectional support for advanced machine learning platforms. This integration is designed to push and pull data to automate analysis.
When a claim is filed, photographs of the damage enter the ISi system through three channels:
agents uploading files via ISi
insureds submitting images via mobile links, or
a special email inbox.
Crucially, the ISi system preserves the original metadata (including timestamps and GPS coordinates) embedded within these images, providing the AI with rich contextual data.
Once a new transaction occurs or a photo is attached to the claim, ISi can automatically push a data packet, along with secure links to the uploaded files, directly to the AI provider. The machine learning platform analyzes the policy data and the images. Following the analysis, the AI system automatically replies to ISi via web services to trigger immediate automated actions.
AI can then prompt ISi to:
add an active task for an adjuster.
append detailed notes to the claim.
send an automated email to the insured requesting additional information.
Streamlining Adjustments with Third-Party Integrations
Automated insurance claims processing requires constant communication with external vendors, field adjusters, and repair shops. ISi eliminates the challenge of manual data sharing by utilizing its Electronic Data Transfer framework to interface with third-party platforms.
When a claim requires an inspection or field adjustment, ISi uses automated maintenance jobs to package the claim details into specialized XML or JSON packets. ISi then:
retrieves essential policy documents (like declarations page in force on the date of the accident),
generates PDFs, and
uploads the entire package to the third-party vendor via FTP or web services.
As the external adjuster works the claim in their native software, ISi actively retrieves real-time updates. ISi then automatically imports new data elements, claim statuses, adjuster notes, and newly generated files (such as inspection reports or photos) seamlessly back into ISi.
Accelerating Claim Payments
Automated claim workflows help accelerate claim payments, which is important for both operational efficiency and customer retention.
Traditional insurance payouts often rely on slow, manual check-printing processes. ISi modernizes the process by fully supporting digital and automated financial distributions.
For third-party vendors, repair shops, and external adjusters, ISi has built-in functionality to bypass paper checks and pay claim vendors directly via ACH electronic transfers. The system then accommodates "no check transactions" for internal ledger balancing and automated salvage and subrogation processing.
ISi's ecosystem also integrates DisburseCloud, which can instantly issue virtual claim payouts directly to policyholders' bank accounts, Visa cards, or digital wallets, bypassing postal delays and dramatically speeding up the indemnification process and potentially avoiding costly lawsuits.
Improving Customer Satisfaction Through the Policyholder Portal
Ultimately, the goal of reducing processing times and errors is to improve customer satisfaction by avoiding long, drawn-out processes. In today’s digital landscape, policyholders expect real-time transparency and instant access to their claim status too. ISi has a standalone Policyholder Portal.
This portal has an independent codebase to protect sensitive internal systems, and it communicates with the core ISi database exclusively through secure web services. Policyholders can log into the mobile-friendly dashboard to view their claim status, along with performing other self-service tasks.
ISi includes a dedicated "Claim Information for Insured" interface designed for adjusters to send a simplified, consumer-friendly status message (e.g., "Waiting on police report") and select specific claim documents (such as letters or estimates) to be instantly visible on the insured's portal.
The ISi communications framework supports dynamic verbiage, automatically pulling data like the claim number or the accident date into the automated message.
Claims don’t have to be messy and drawn out. See how ISi can help you better manage claims workflows and automate other processes during the entire lifecycle of a policy. Request a demo today.