PLAYBOOK · INSURANCE
An on-prem claims processing network from FNOL to settlement.
FNOL intake, document OCR, coverage check, fraud signal, payout decision — every stage is a sub-intent. This playbook orchestrates them as one VDF AI Network with end-to-end traceability.
The problem
Claims still move paper
Even digital claims arrive with scanned receipts, photos, policy PDFs, and free-text descriptions. Adjusters spend hours on data extraction before they get to the decision.
The VDF AI approach
One network, every stage
OCR built-in. Policy vectors in pgvector. Rule agents wired to your engine. Approval routing baked into the Network. A claim enters; an evidence-backed decision exits.
REFERENCE ARCHITECTURE
FNOL to settlement, one network
email · portal · API
Rule engine
Intent: process-claim
PLAYBOOK · STEP BY STEP
From FNOL to evidence-backed decision
Ingest the claim
FNOL hits a Custom HTTP tool that routes payload + attachments into the Network.
OCR + structured extraction
The built-in ocr tool plus an extraction agent turn images into typed fields with provenance.
Coverage retrieval
Policy documents are vectorized. The Coverage Agent finds the right clauses, cites them, and feeds them to the rule engine.
Decision and approval routing
The Payout Agent emits a decision; the Network routes by authority threshold to auto-approve, adjuster, or fraud team.
Audit and learn
Every claim's run is replayable. SEEMR optimizes which model handles which sub-task.
OUTCOMES
Throughput and trust at the same time
average cycle time on routine claims.
evidence packs include OCR provenance + policy citations.
fraud team focus on real signals, not data wrangling.
SEEMR REFERENCE
Adjuster time goes to real decisions
SEEMR learns which sub-intent (extraction, coverage, fraud) maps to which model, balancing cost, latency, and accuracy.
GET IN TOUCH
You Have Questions
Tell us what you’re trying to achieve—governed AI Networks, enterprise RAG, deep integrations, or on‑premise deployment. We’ll help you map the right architecture, security posture, and rollout path. If you’re moving beyond AI pilots and need scalable, auditable execution, reach out—our team is ready to help.