AI Claims System Integration Agent

How Cassidy automates Claims System Integration using AI

Step 1: Trigger on structured FNOL or triage output

The Workflow activates when AI-processed FNOL data or triage scores are ready for sync—whether from your intake automation, document extraction pipeline, or external partner feed.

Step 2: Validate and enrich the payload

Cassidy checks the incoming data against your schema requirements, validates policy and coverage details, and enriches with external data sources like fraud signals or geocoding before handoff.

Step 3: Map to your core system's data model

Cassidy transforms the canonical FNOL payload into the exact format your claims platform expects—whether that's ACORD XML, REST API parameters, or custom field mappings for Guidewire, Duck Creek, or Sapiens.

Step 4: Create claim and attach artifacts

Cassidy calls your core system's APIs to create the claim shell, populate exposures and coverages, set initial reserves, and attach supporting documents, notes, and triage scores.

Step 5: Route and assign with Human-in-the-Loop controls

Based on triage outputs, Cassidy triggers assignment rules—routing to fast-track queues, specialist adjusters, or SIU referral—with approval gates for high-severity or flagged claims.

Step 6: Emit events for downstream orchestration

Once the claim is created, Cassidy publishes events to trigger follow-up Workflows: claimant communications, inspection scheduling, estimate requests, or payment authorization flows.