Insurance Claim Agent

An agentic A360 process uses GenAI Vision to extract and validate insurance claims against policy rules and automatically emails the insurer for processing

Top Benefits

  • Enables end-to-end automation, reducing manual effort and operational costs
  • Improves accuracy and consistency through AI-driven policy validation
  • Accelerates claim processing and insurer communication
  • Ensures compliance with company rules while scaling effortlessly with volume

Tasks

  • Document automation extraction
  • Document automation download extracted data and read data from .CSV
  • Pass the field values to AI skill
  • passing field values to the insurance agent for validating with company policies or rules for a claim to process
  • after validation passing field value and validation status to the email agent to send a email to the insurer to process

An agentic process has been implemented in Automation Anywhere A360 using Document Automation with GenAI Vision to automate insurance claim validation and communication.

Document Ingestion & Extraction

Insurance claim documents are ingested using Document Automation (GenAI Vision).

Required claim fields are intelligently extracted and stored in a CSV file for downstream processing.

AI-Driven Validation

The extracted CSV data is passed to an AI Skill and an Agentic AI Agent.

The agent validates the claim details against company policies and predefined business rules (e.g., mandatory fields, value thresholds, eligibility criteria).

Decision & Orchestration

The agent autonomously determines whether the claim meets validation requirements.

This decision governs the next action without manual intervention.

Automated Email Communication

If validation is successful, an Email Agent automatically drafts and sends a structured email to the insurer, requesting claim processing.

The email includes all relevant validated claim details to ensure faster turnaround.

Outcome

The solution enables end-to-end, touchless claim processing, reduces manual effort, improves accuracy, ensures policy compliance, and accelerates insurer communication.

Access Now

Free

Applications
Business Process
Category
Vendor
Automation Type
AI Agent
Last Updated
January 21, 2026
First Published
January 21, 2026
Platform
Automation 360
ReadMe
ReadMe
Support
Bot Security Program
Level 1

See the AI Agent in Action

Insurance Agent
email Agent
Ai Skill
Final email to the insurer to process the Claim
Full process image
Passing input from form to the insurance Agent
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Insurance Agent
email Agent
Ai Skill
Final email to the insurer to process the Claim
Full process image
Passing input from form to the insurance Agent

Setup Process

Install

Download the AI Agent and follow the instructions to install it in your AAE Control Room.

Configure

Open the Bot to configure your username and other settings the Bot will need (see the Installation Guide or ReadMe for details.)

Run

That's it - now the AI Agent is ready to get going!

Requirements and Inputs

  • health insurance claim application pdf
  • Motor insurance claim application pdf
  • Property insurance claim application
  • Outlook
  • Csv/excel

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