Insurance
Claims from FNOL through settlement, underwriting auto-decisioning, fraud detection. Sub-line specialisation across health, motor, and property on Pega.
Insurance use cases — from Pega, Kore.ai & AWS
Proven AI patterns for insurance enterprises — sourced from Pega, Kore.ai, and AWS production deployments. Novitates implements these inside your governed platform.
Pega Claims — FNOL Triage (9d→3.4d)
GenAI document triage + fraud-aware decisioning inside Pega Customer Service. Top-10 insurer: claims cycle from 9 days to 3.4 days. Sub-15-minute FNOL intake. Regulator-grade audit trail.
Pega Underwriting — Multi-line Auto-Decisioning
Risk scoring, policy fit analysis, exception routing across health, motor, property. IFFCO Tokio: 41% policies auto-decisioned, underwriter review time ↓65%. IRDAI-aligned governance.
AWS IDP — Insurance Document Intelligence
GenAI IDP converts unstructured insurance documents (claims forms, medical records, damage photos) to structured data. Rule validation against business rules and compliance criteria. Near-human accuracy.
Kore.ai — Insurance Customer Service Voice
Agentic contact center: AI handles billing queries, plan questions, claims status — 24/7 across multiple languages. Kore.ai insurance chatbots: instant quote, claim filing, policy renewal via voice.
Pega Knowledge Buddy — Policy Q&A for Underwriters
Underwriters drafting policies, compliance analysts responding to IRDAI/HIPAA regulation impacts — GenAI Knowledge Buddy with enterprise grounding retains human final say and full auditability.
Prudential — Multi-Agent Insurance Advisor (AWS)
Prudential built life insurance advisor on AWS multi-agent architecture. Orchestration agent routes to specialist sub-agents for quotes, forms, products, illustrations, and book management.
AWS Bedrock — Claims Sentiment & Voice Analytics
AWS Transcribe enables voice analytics and compliance checks in claims calls. Amazon Kendra semantic search surfaces relevant policy sections for adjusters. Deployed inside client AWS tenancy.
Pega Fraud Detection — Real-time Signals in Case
AI fraud signals integrated into Pega claims and underwriting cases. Real-time scoring with human decision point on flagged cases. Every signal logged as a case event. Regulator-walkable.
Kore.ai — Policy Renewal & Premium Collection
Automated renewal reminders, premium collection via voice and chat. Kore.ai insurance chatbots: document uploads, coverage comparison, benefits explanation — fully automated at scale.
Use cases sourced from Pega, Kore.ai, and AWS published documentation. Novitates implements these patterns inside your enterprise environment on Pega and Kore.ai.
BFSI-native. Platform-deep. Outcome-based.
Platform-native AI
Pega and Kore.ai — not generic AI tooling bolted onto your stack. Every AI decision logged in the platform's native audit trail. No additional logging infra.
Outcome-based commercials
Fixed-outcome engagements. Per-transaction pricing. 20% held in escrow against delivery. We share commercial risk with you on every engagement.
Inside your perimeter
Your AI licence. Your data residency. Your tenancy. We engineer inside your approved security boundary — your CISO doesn't need to approve a new vendor.