Touchless
Claims.
From 15-day claim processing to under 24 hours — while detecting fraud and personalizing policies in real time.
Challenge: Speed vs. Fraud
Insurance is the business of trust — but trust is built or destroyed in the moments that matter most: when a customer files a claim. Our client, a regional insurer, was averaging 15+ days to process claims, creating frustration and churn at exactly the moments when customer loyalty is most fragile.
The opposite pressure was equally severe: fraudulent claims were costing approximately 7% of the annual claims budget. Manual fraud investigation was slow, inconsistent, and often inconclusive. Adjusters were overwhelmed with routine documentation review, leaving little capacity for the complex fraud cases that required genuine human judgment.
The challenge was not to choose between speed and accuracy — it was to achieve both simultaneously by automating routine claim assessment while focusing human expertise on genuinely complex cases.
Solution: ClaimSense Platform
Ishiros built ClaimSense — a three-layer AI platform that automates routine claim assessment, detects fraud signals at the point of submission, and personalizes policy offerings based on actual risk behavior rather than demographic proxies.
1. Neural Damage Assessment
A Computer Vision model analyzes vehicle or property photos submitted via mobile app, assessing damage type, severity, and estimated repair cost within 3 minutes of submission. For 80% of straightforward cases, this enables same-day payout authorization without any adjuster involvement — freeing experts for complex cases.
2. Metadata Fraud Protection
Every submitted photo is analyzed for metadata inconsistencies (timestamp, GPS location, device information) and cross-referenced against weather databases, police reports, and historical claim patterns. The system calculates a fraud probability score and automatically flags suspicious claims for priority human review — without slowing down legitimate claimants.
3. Hyper-Personalized Policy AI
Usage-Based Insurance (UBI) models analyze real driving behavior, property maintenance patterns, and historical claim frequency to generate individual risk profiles. Policyholders who demonstrate safe behavior receive lower premiums dynamically — creating a positive feedback loop that rewards good risk management and improves portfolio quality.
Technical Foundation: LLM + Computer Vision Orchestration
ClaimSense orchestrates LLMs for document understanding with OpenCV-based Computer Vision for damage assessment. Tesseract OCR handles document digitization from scanned claim forms. All photo uploads from mobile are encrypted with TLS 1.3 before transmission, and assessment models run in a secure enclave ensuring GDPR compliance.
NPS increased by 45 points in the 12 months following deployment — driven primarily by the dramatic improvement in claim resolution speed. Processing time dropped from 15 days to under 24 hours for 80% of cases. The remaining 20% of complex cases now receive better adjuster attention because routine work is handled by AI.
"Insurance is no longer sold based on fear, but on trust and service speed. Ishiros allowed us to be there for customers in their hardest moment — literally within minutes. That kind of experience builds loyalty that no marketing campaign can buy."
Next Steps
Claims Data Audit
We analyze your historical claims, fraud patterns, and current processing bottlenecks to design the optimal automation scope.
CV Model Training & Integration
We train damage assessment models on your specific claim types and integrate with your existing claims management system before go-live.