Insurance Sector

Damage Claim & Fraud Dedection Process

Business Challenge

  • Manual Processing of Insurance Claims
    Leading insurance companies faced significant operational deficiencies in handling post-accident claims. Manually processing over 1500 records and over 6500 documents per month, such as accident photos, driver statements, official reports, and license information, required significant effort from operations teams. These steps resulted in delays, increased risk of human error, and impacted customer satisfaction, especially when documents were missing or incorrectly submitted.
  • Complex Business Rules
    Every record and the documents related to the records had to be validated according to the rules. The variety of documents included separate rule sets for each document type and the checks based on these rule sets.
  • Document Accuracy Checks
    Each document varies depending on the institution and personnel filling out the accident report, and the variety and density of documents make document checks difficult and increase the risk of errors.
  • High Operational Load
    These manual verifications created a significant workload for insurance personnel, increasing the potential for human error and causing frequent delays in accident insurance processing.
  • Employee Satisfaction
    Long turnaround times for approval or denial negatively impact employee morale and confidence in the reimbursement process, while also increasing compliance risks for the organization.

Insurance / Damage Claim / Fraud Detection

Agentic AI - Damage Claim and Fraud Detection Process

Application

Applications Through Multiple Channels

Custom End User Screen Design for the Process. Autonomous Dialogue Design with GPT-4o. Automated Email Responses and Spam Detection. Monitor changes and updates through WhatsApp, Email, Microsoft Teams, Power Apps, Client and Mobile Apps

Document Classification

Classify Documents by Type and Split into Appropriate Pages

Analyze the Text and Identify the Request. Normalize the Data Found in the Text. Write Extracted Data to a Shared Data Service. Download Email Attachments and Split Documents Appropriately. Classify Documents based on Their Type

Data Extraction

Extract Data with Customized AI and Fraud Models

Vehicle Registration and Accident Report Processing. Extract structured data from different types of documents. Process accident photos and damage statements. Digitize handwritten statements and normalize data

Photo Analysis

Retrieve Additional Information from Different Systems

Recognize License Plates in Photos. Detect Vehicle Colors. Identify Vehicle Positions. Analyze and Interpret Damage Probabilities. Generate Possible Accident Scenarios. Provide Information About Location and Surrounding Details

Fraud Detection

Submit for Approval or Review if Necessary

Compare the declared information with the current system records. Find inconsistencies in the declared information and the shared photo. Analyze similarities with previous frauds detected. Query the applicant from Authority and check vehicle information

Final Processing

Payment Order or Alert to Fraud Team

Generate Payment Order for Valid Claims. Alert Fraud Team for Suspicious Cases. Integration with Mainframe and ERP Systems. Update case status and generate final reports. Notify stakeholders of the final decision

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Application Processing

How Agentic AI Helped

  • Multi-Channel Application Intake
    Requests can be submitted via WhatsApp, email, Microsoft Teams, Power Apps, or mobile apps.
  • Document Interpretation & Classification
    Agentic AI classifies documents by type and splits them into appropriate pages.
  • Agentic AI Data Extraction
    Specialized Agent extracts key data from accident photos, damage statements, and registration documents.
  • Fraud Detection and Review
    Agentic AI cross-checks data for inconsistencies, allowing early detection of potential fraud.
  • Automated Escalation & Resolution
    If human review is needed, cases are routed to manual approval screens for real-time resolution.
  • System Integration & Business Orchestration
    Once validated, data is automatically logged in Company's mainframe and data-storage systems for payment or fraud reporting.
  • Photo Detection and Interpretation
    Agentic AI analyzes uploaded accident or damage photos, detects relevant elements, and supports automated claim validation.
  • High-Accuracy Handwriting Recognition
    Extracts data from handwritten forms with strong accuracy, even in challenging real-world submissions.

Results

  • Claim Processing Time Reduced by 95%
    Most claims are now processed within 24 hours instead of the previous 5–7 business days.
  • Error and Rejection Rates Dropped by 90%
    Thanks to Agentic AI communication and validation checks.
  • Increased Compliance and Audit Readiness
    Every action is traceable through structured output generation and logging.
  • Enhanced Customer Satisfaction
    Faster and more transparent handling of claims led to higher trust and engagement from policyholders.
  • Process Automation at Scale
    Successfully automated over 1500 monthly accident forms & 6500 documents, eliminating manual data control and reducing processing time from days to minutes. This automation freed up significant human resources for more strategic insurance-related or risk-management-oriented activities.
  • Smart Error Handling with Photo & Handwriting Intelligence
    Agentic AI resolves complex input issues by interpreting photos and accurately extracting data from handwritten forms—capabilities beyond traditional systems. This reduced rejection rates by 90% and minimized back-and-forth with users.

Simplifying Complex Operations Through Automation-as-a-Service

  • “Working with Unite is always insightful and visionary. As one of the pioneers in the field, their innovative mindset keeps us progressing with every new product and technology always outcome-driven, fast, and accurate.”
    Mehmet Özbek
    Process Automation Technical Leader - Ford Otosan
  • "Thanks to their expertise and right product/technology selection, we have accomplished many projects that were once considered ‘impossible."
    Nilay Sarı
    Process Automation Services Product Owner - Ford Otosan

Unite powers transformation through AI, automation, and orchestration—where you only pay for results.

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London

Unite Information Technologies UK LTD
Second Floor, 3 Liverpool Gardens, Worthing, West Sussex, BN11 1TF London/UK
Tel: + 01903624664

Istanbul

Cumhuriyet Mah. Abdi İpekçi Cad. Mermer Sok. No:4 Kartal 34876 İstanbul/Türkiye
Tel: +90 (216) 453 40 00

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