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Claims team

Insurance

Where agents triage claims and read medical records — first notice to payout, every decision evidenced.

Loss adjustment expense is the cleanest return in your business.

Loss adjustment expense (LAE) runs 10–15% of losses paid. Automation saves US$300–500 per claim in labour against roughly US$10 in technology. That ratio needs no modelling — it needs your volume.

Agents cut LAE in every season

LAE sits on the face of your combined ratio and moves whether or not a storm makes landfall.

Agents run straight-through when it counts

In a catastrophe, straight-through processing is the only lever that scales — built before the water rises.

Agents make being wrong visible

A misread date of service surfaces eighteen months later. The product is the score, the routing and the record.

What agents complete here

Completed into the claims platform, the policy admin system or the TPA's case system — evidence attached.

First notice of loss (FNOL) and claim triage

Agent decides intake, coverage, severity and routing and records the source page behind every field — routed to a named adjuster when coverage is ambiguous.

Medical records and hospital invoices

Agent reads handwritten, scanned and annotated records and scores every field — routed to a named examiner when confidence is low.

Underwriting evidence

Agent checks physician statements and lab results against guidelines and evidences the decision — routed to a named underwriter when a guideline is not met.

Bill review and bordereaux

Agent reconciles codes, dates and amounts and flags variances with the page — routed to a named reviewer when a variance is material.

Why insurers and TPAs choose Densery

We don't drop AI into one function. We complete the claim file and leave the evidence a carrier's audit team accepts.

The hardest document, first

A workers-comp medical record has resisted automation because being wrong is expensive and invisible. That is what the evidence layer is for.

Audit-ready by construction

What the machine decided and what the human changed, in one immutable record.

Deployed your way

On-premise for state funds and carriers under a residency obligation; hosted where it is a preference.

Capacity TPAs can sell

The same adjusters handling more files, with an evidence record for the carrier's audit team. One deployment, every client.

Bring your own AI

Assessors keep the assistant they know. It reads the claim through Densery, with the policy rules and the evidence trail attached.

Insurance · Vietnam

A top-three life insurer — underwriting and claims answered in the app, not in weeks.

Workflows
Underwriting · claims
Wait time
Weeks → immediate
TPA
Brought in-house

What it proves

Hospital records, invoices and discharge papers in every format, read and checked against the policy by agents. Straightforward claims are answered in the customer app as soon as the documents arrive; the insurer brought third-party administration back in-house and cut the cost of the claims operation.

Where else this applies

Every life and health carrier in Southeast Asia — and every bancassurance partnership — runs on the same third-party clinical documents, with no control over format and an expensive consequence when a detail is missed.

Read the deployment →

Who this is for.

If your data can go anywhere and your documents are already clean and digital, you do not need us.

OrganisationSizeWhy
Life, health and general insurersContinuous claims and underwriting volumeEnough file volume to clear the technology cost several times over — and a customer waiting on every file.
Bancassurance partnershipsAny scaleThe bank's customers expect the bank's response time. Weeks is not it.
TPAs and claims servicesSeveral carrier relationshipsOne capability serves every client; or the carrier brings the work back in-house.
Not a fit Insurtechs with clean digital intake—Structured data, no document estate to solve.

Bring twenty claim files. Leave with your loss-adjustment number.

One process first, live in under three weeks, with the evidence from day one.