Underwriting, claims and fraud AI

AI that pays claims faster and prices risk sharper

T7 builds AI systems for insurers that pre-adjudicate claims, augment underwriters and catch fraud earlier — across health, motor, life and P&C.

Why Insurance & InsurTech needs AI now

Insurance runs on documents, decisions and disputes. T7 Solution ships AI that reads claim files, drafts underwriting notes and scores fraud risk — while keeping every decision explainable to your regulator and your customer.

We work across health, motor, life and commercial P&C. Every deployment integrates with your core system (Guidewire, Duck Creek, custom mainframes) and preserves the audit trail regulators expect.

Explainability is default: SHAP-based reason codes on every ML score, citations on every LLM output, and a review UI for adjusters to accept, reject or override.

Challenges we solve

Claim leakage

Manual adjudication misses fraud and overpays leakage — often 5–10% of settled value.

Cycle time

Complex claims take weeks; NPS and regulator scrutiny both suffer.

Underwriter capacity

Senior underwriters spend hours per case on document review instead of judgment.

Vernacular support

Retail policyholders want service in their language — call centres can't scale it.

AI use cases for Insurance & InsurTech

Claims automation

OCR + LLM extraction on claim forms, bills and medical evidence; straight-through processing for clean claims.

Underwriting copilots

Retrieval over policy wordings, actuarial tables and past decisions to draft first-pass underwriting notes.

Fraud detection

ML models that score claims for fraud risk using structured + image evidence.

Policyholder self-service

Voice and chat agents for renewals, claims status and endorsements in vernacular languages.

Outcomes clients see

55%
Straight-through claim processing
3–7%
Loss ratio improvement from fraud scoring
10x
Vernacular self-service coverage

Tech we use

Azure Document IntelligenceOpenAI GPT-4XGBoostGuidewireDuck CreekTwilioWhatsApp Business API

Insurance & InsurTech AI, by city

Explore how T7 Solution delivers insurance & insurtech AI locally — with on-site discovery, compliance patterns and language coverage tuned to each market.

Frequently asked questions

Is this regulator-friendly?

Yes. Every decision — LLM or ML — ships with a reason code and full lineage. We produce model cards and validation packs suitable for IRDAI, PRA and NAIC review.

Do you integrate with Guidewire and Duck Creek?

Yes, via REST, EDI and direct DB. We've integrated AI decision layers into both without disturbing the core policy administration system.

How do you avoid unfair discrimination in pricing/scoring?

Protected-attribute testing on every model, bias audits before go-live, and continuous monitoring for drift on fairness metrics.

Can you handle health claims with medical evidence?

Yes — including prescriptions, discharge summaries and diagnostic reports in English and Indic scripts. Extraction routes low-confidence fields to human review.

Ready to Build Your AI Product?

Talk to a senior AI consultant from T7 about your industry, workflow, or product idea. Free, no commitment — reply within one business day.

  • · AI feasibility & architecture review
  • · Product / MVP roadmap
  • · Integration & automation strategy