# FNOL to wire in one AI pipeline
> From the first photo to the final wire, Claims AI handles everything. A vision model reads the photos, an LLM reconciles coverage against the bound policy, a triage agent drafts priority and risk flags, and the adjuster supervises at the exception boundary. Simple claims close themselves. Hard ones land on a desk with the reasoning already written down.
Canonical URL: https://www.sureapp.com/platform/claims-ai
Module slug: claims-ai
Category: Platform
## Claims as a pipeline

Claims are typed steps: intake, extraction, coverage, reserve, authority, payout, recovery, close. Agents do the work. Adjusters supervise at the exception boundary, with SLA timers and audit trails running underneath.
### Omnichannel FNOL
Photo, video, voice, SMS, web form, or carrier-feed event lands on a single event consumer. Normalized to one claim schema, made ready by AI for next steps.
### AI-powered triage
A triage agent reads the claim, writes priority, complexity, risk flags, and recommended actions to a typed schema. Vision extraction handles image FNOLs and returns structured claim data the adjuster can accept or edit.
### Reserve automation
Opening reserves post when coverage lines land. The reserve ledger tracks current, paid, and outstanding amounts, and writes every change with the previous value, new value, delta, and reason. Workspaces choose how strictly the ledger enforces reserve limits on payments.
### Same-day settlement
Payments within authority auto-approve and route to a batch. ACH, card push, check, and carrier draft are supported rails. Outside the limit, the transaction stays pending until an authorized approver signs.
### Subrogation
The platform tracks liable party, expected amount, demand sent, response, settlement. Recovered dollars post back against the same claim ledger so net economics stay honest.
### Decision-ready cases
Exceptions route to an adjuster with coverage analysis, loss items, triage priority, risk flags, and a recommended action. Not a blank form. The adjuster accepts, amends, or overrides in one motion.

## AI agents do the work. People supervise

Insureds open claims from anywhere. Adjusters supervise from a prioritized queue. Engineers wire the pipeline to their stack.
### Intake anywhere (For insureds)
SMS link, branded web page, in-app photo capture, or voice. The claim opens itself. Insureds get live status updates.
### The supervising queue (For adjusters)
A prioritized queue of exception claims, each with a decision-ready packet. Accept the agent's scope, or amend it in a click. Rebalance reassigns open claims in one call.
### Claims API and agent hooks (For engineers)
A typed Django REST API for claims, extractions, transitions, reserves, transactions, and recoveries. Webhooks fire on every state change.

## Fast resolution without settlement mistakes

Coverage, authority, SLA, and audit enforced at the ledger. Agents move fast because the edges are hard.
### 01. Coverage enforced at time of loss
Every claim is hydrated against the bound policy snapshot for the loss date. Coverage lines carry limits and deductibles from the filed product. Out-of-coverage losses refuse to reserve.
### 02. Authority envelopes on every payment
Claims AI sets a per-user, per-cost-type ceiling. Payments within the limit auto-approve and post. Over the limit, the transaction stays pending until an authorized approver signs.
### 03. SLA timers on every status
Each status transition creates SLA deadlines and resolves the prior ones. Late-cycle claims escalate automatically. Regulatory timing requirements run as timers on the ledger so nothing slips past a deadline.
### 04. Agent reasoning logged
Every triage run writes a typed report with priority, complexity, risk flags, and recommended actions. Every extraction stores source-tagged fields.
### 05. Reserve enforcement modes
Choose how strictly the ledger holds the line when a payment would exceed its reserve. Block it, warn and allow it through, or raise the reserve to cover it and log the change. Each workspace picks the mode that fits its business.
### 06. Human approval at the exception boundary
Agent-drafted communications wait for an authorized user to approve them before they go out. Closing a claim is gated too. Every active coverage line must be closed or denied first.

## What the pipeline supports

- FNOL channels: SMS · Web · iOS · Android · Voice · Carrier feed · REST API
- Lines supported: All P&C, A&H, E&S, commercial, and specialty lines. Including: HO · DP · Renters · Auto · BOP · Disaster · Term life · AD&D · Home warranty
- Time-to-first-payment: Simple claims under 30 seconds
- Payment rails: ACH same-day · Card push · Check · Carrier draft
- Zero-touch close rate: 68% of eligible claims close without adjuster touch
- Audit: Observable and actionable audit trails. Workspace-scoped, SOC 2, SIU replay, regulator export.

## Key metrics

- 68% — Of eligible claims close agent-to-settlement with zero human touch
- 3h — p50 time-to-first-payment across all claims, all lines
- 4.8★ — Average insured satisfaction after a Sure-handled claim

## Customer quote

"Chubb's insurance offering, through Sure's technology platform, further reinforces our commitment to innovative, digital solutions and providing consumers with peace of mind."
— James Walloga, EVP Accident & Health, Chubb North America

## See the platform up close

Get a walkthrough with the team at Sure. We'll dig into the platform and how we impact your roadmap.
Primary action: Book a walkthrough