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Automate Coverage Verification Checks

Benefits:

Accuracy, Speed, Compliance

Category:

Claims Processing & Management

Use Case

Before processing a claim, adjusters must verify that the loss is covered under the specific policy terms, conditions, and exclusions. This can involve careful reading of complex policy language. LLMs can automatically compare the details of a submitted claim against the relevant policy document, verifying coverage, checking limits and deductibles, and flagging any potential exclusions. This speeds up verification and reduces the risk of paying non-covered claims.

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