Claims Triage Agent
The Claims Triage Agent reads each new claim and its supporting documents, checks the loss against the policy schedule and wording, and scores it for complexity and fraud signals. Every claim reaches the right handler on the day it arrives, with a recommended next step and the policy clause behind it.
Ideal forClaims teams
The difference
From 45-60 minutes to 2-3 minutes per claim
Your claims team spends its time settling and assessing claims, not reading and sorting them.
Done by hand
45-60 minutes per claim
With the Vanine agent
2-3 minutes per claim
Time returned to your team
90%
Indicative figures. We measure your own baseline in the first fortnight so the numbers you see are yours.
Faster settlements for simple claims
Straightforward claims with clear cover go to fast-track handling on day one, which is what policyholders remember when renewal comes around.
Assessors on the claims that need them
Complex and high-value claims are routed to experienced handlers and assessors, with the cover questions already set out.
Fraud signals caught early
The agent flags inconsistencies across documents, recent policy changes and known patterns, so your fraud unit sees them before a payment is made.
Capabilities
Every claim read, checked against cover and routed on the day it lands.
Built for claims teams, assessors, fraud units and operations managers at South African short-term insurers, UMAs and brokers.
Claims intake
Reads claim forms, emails, photos, quotes and police reports, and turns them into a structured first notice of loss.
Cover checks
Tests the loss against the policy schedule, wording, excesses and exclusions, and cites the clause that applies.
Fraud signals
Flags inconsistent dates, amounts and descriptions, recent cover changes and repeat claimants for your fraud unit.
Complexity scoring
Scores each claim for value, complexity and urgency so it goes to fast-track, a handler or an assessor.
Missing information requests
Lists what is still needed from the policyholder or broker and drafts the request in plain language.
Treating customers fairly trail
Records every decision and the reason for it, so you can show TCF outcomes and respond to the Ombud with evidence.
How it works
From your systems to a result you sign off
Handlers and assessors make every cover and settlement decision. The agent recommends, it never declines a claim.
Connect the places your claims records already live.
New claims from your claims system, inbox and broker portals, and the policy schedule and wording from policy administration. Already use something else? We connect that too.
- OpenAI Frontier
- Your own AI platform or models
- Microsoft 365 (Teams, SharePoint, Outlook, Excel)
- Claims and policy administration systems
- Claims inbox, broker portals and WhatsApp intake
- Assessor and fraud case management tools
Runs as each claim is lodged, or on request in Teams, using the models your organisation approves.
A triage summary, cover view and recommended route written back to the claim in your claims system.
Step by step
- 01
A claim is lodged by a policyholder or broker.
- 02
The agent reads the claim, its documents and the policy.
- 03
It checks cover, excesses and exclusions against the wording.
- 04
It scores complexity and flags any fraud signals.
- 05
It routes the claim with a recommended next step and any missing information.
- 06
Your handler reviews and makes the decision.
Deployment
Runs inside the tools your team already uses
The same agent and the same cited output, delivered three ways: through the AI assistant you have rolled out, on a model you host yourself, or inside your own software.
In the frontier assistant you already pay for
We publish the agent as an MCP server. Add it as a connector and your team calls it from the chat they use every day, with no new tool to learn.
"Read the new claim from the broker portal"
- batch
- Overnight 29 Sep
- product
- Personal lines
On a model you host yourself
Run the agent on open-weight models in your data centre or private cloud. Your claims records never leave your network, which keeps POPIA and data residency straightforward.
- Llama
- Mistral
- Ollama
- or any OpenAI-compatible endpoint
Inside your own software
Trigger a run from your own workflows, and push the finished output into your ERP, GRC or reporting systems. We build the integration with your team.
- REST API
- Webhooks
- Batch jobs
- Embeddable review panel
Governed the same way, every route
Whichever way your team reaches the agent, identity, permissions and audit stay with your existing controls.
- Single sign-on through Entra ID, Okta or Google Workspace
- Reads only the documents each user is already allowed to open
- Every tool call written to an audit log you can export
How we deliver it
One agent, three ways to hold it
Start where your team already works, then take it as far into your systems as the value justifies.
DATA SECURITY & PRIVACY
Your claims records stay yours.
The agent runs inside your tenancy, reads only what each task needs, and never trains on your claims records. Every step is logged so your auditors can see exactly what it touched.
Built for regulated work.
+YOUR CLAIMS RECORDS NEVER LEAVE YOUR ENVIRONMENT
More agents
More agents we build for South African enterprises
Each one is built on the same foundation: your documents, your rules, and your people signing off.
Precision AI for Institutional Workflows
