AI Agents for Insurance Claims & Underwriting | Pokee AI

Customers First. Trust at Every Step.

AI agents remove friction, automate decisions, and deliver satisfying experiences across claims, underwriting, fraud, policy intelligence, and billing — with governance and audit trails carriers expect.

Capabilities

Resolve Faster. Underwrite Smarter. Stay Investigation-Ready.

Claims automation, underwriting workbenches, policy intelligence, and fraud-aware workflows — with governance and audit trails carriers expect.

Claims

Intake → Resolution, with Traceability

Structured extraction from any channel, coverage checks, reserves, and audit-ready decisions — every step logged and replayable for QA and regulators.

Underwriting

Evidence-Backed Submission Review

Risk signals, guideline alignment, and explainable recommendations grounded in policy and regulatory context — straight-through where it counts, referral where it matters.

Fraud & Compliance

Anomaly Scoring with Escalation Paths

Real-time anomaly scoring, specialised enrichment agents, and investigator-ready exports — designed for compliance teams that need a defensible paper trail.

Impact Highlights

Workflow Showcase

Elevate Policyholder Experiences. Reduce Claims and Underwriting Overhead.

Two production workflows live in deployments today — the End-to-End Claims Processing Agent and the Intelligent Underwriting Workbench — both wired to your policy corpus, your claims systems, and your guidelines.

Workflow Use Case · 1: End-to-End Claims Processing Agent

Intake → Assessment → Decision with full traceability — for claims operations and adjusters, aligned to our full claims demo.

Workflow Use Case · 2: Intelligent Underwriting Workbench

Submission intake, enrichment, and guideline-aligned decisions — for underwriters and managers, aligned to our underwriting demo.

Foundation Models

Command

A family of high-performance generative models.

Embed

A model for semantic text representation.

Rerank

A model for relevant search results.

Get Started

Move your insurance roadmap from pilot to production.

Connect with our team to scope an agent that fits your policy corpus, your guidelines, and your regulator’s appetite for risk.

Deployment & Governance

Private Deployment

A dedicated managed tenant, your own VPC on AWS, Azure or GCP, on premises, or air-gapped. Your data never leaves your boundary.

Approvals and Audit

Approval gates wherever you set them, role-based access, and a full audit log. Every agent action is attributable and reviewable.

Measurable Pilots

Pilots run on two or three real workflows, typically live inside two weeks. Measure time saved, accuracy and cycle time before rollout.