INSURANCE

Claims processing coworker for a retail and commercial insurer

Growing claim volumes and unstructured document sets were slowing settlement. Wexa ran a proof of concept automating intake, extraction and validation.

Download this case as PDF Book a demo

claims processing time
field-extraction accuracy at launch, rising with feedback
manual re-entry into the claims system

CLIENT: Retail and commercial insurance group
REGION: Confidential
WHEN: 2025
ENGAGEMENT: Proof of concept
WEXA COMPONENTS: Document ingestion · extraction agents · rules validation · claims-system integration

01Case 26

The challenge

Manual review of large, unstructured claim files
Skilled staff hours lost to data extraction
Human error causing rework and escalations
Seasonal surges straining capacity

What Wexa built

Automated intake from multiple channels with image enhancement
OCR and NLP extraction with document classification and confidence scores
Business-rule validation against policy terms; exceptions routed to reviewers
Outputs synced to the claims system

02Case 26

How it runs on Wexa

FigureHow this use case runs on Wexa: client systems connected, ontology discovered, context graph in the Wexa memory layer, agents and process flows, and governance. Highlighted components are central to this use case.

03Case 26

Solution architecture

FigureDocument-processing architecture used in the proof of concept: ingestion → OCR → field-level extraction with confidence scores → human-in-the-loop validation → core systems. Percentages on the figure are platform design targets.

04Case 26

Results

Measure	Before / without Wexa	With Wexa
Claims handlers for the same claim volume	50 handlers	20 handlers
Annual cost of the process	$2.8M	$1.1M
Time to implement the AI solution	6 months	6 weeks
AI build cost (one-time)	$480K	$44K
AI operating cost per year (models, infrastructure, upkeep, platform)	$312K	$166K
Total AI cost in year 1	$792K	$210K

With Wexa

net annual value to the client after Wexa's own operating cost

faster to implement

lower AI operating cost

less AI spend in year 1

"The Wexa POC proved that AI-driven claims automation can deliver real, immediate value. We processed claims faster, with fewer errors, and freed our people to focus on customers rather than paperwork."

Operations Head, client