Solution
Insurance Claim Bundles Into Claims Intelligence
PrismIQ treats every document in a claim as one case: it classifies each page, extracts the facts, connects them across documents and flags what an adjuster needs to look at.
The problem
Why this process resists automation
A claim rarely arrives as one document. Adjusters receive a bundle — forms, bills, reports, identity documents and photos — and must reconcile them by hand before any decision can be made.
- — Bundles mix scanned, photographed and digital pages in varying order and quality
- — The same fact (policy number, date, amount) appears in several documents and must agree
- — Missing documents are often only discovered after days in the queue
- — Arabic, Urdu and English documents can appear in the same claim
- — Adjuster time is spent on data entry instead of judgement
Today
How the work happens now
- 01Claim bundle received by email, portal or branch
- 02Each page opened, identified and renamed manually
- 03Policy, claimant and amount keyed into the claims system
- 04Bills and estimates checked against the claim form by eye
- 05Missing documents requested from the claimant
- 06File passed to an adjuster for assessment
How PrismIQ solves it
Insurance Claims Intelligence with document intelligence
One case, many documents
All files submitted for a claim are grouped and processed as a single case rather than as unrelated uploads.
Page-level classification
Each page is identified — claim form, bill, estimate, police or medical report, ID, photo — even when they arrive merged in one PDF.
Cross-document claim context
Policy, claimant, dates, treatment or damage, and amounts are linked across documents into one claim context, with the source of each value kept.
Completeness and consistency checks
Required documents are checked against the claim type, and values that disagree between documents are flagged instead of silently accepted.
Adjuster-ready review
Exceptions go to a reviewer with the original page highlighted beside the extracted value, so decisions are made on evidence.
Decision stays with people
PrismIQ prepares and validates the file. Liability, coverage and settlement decisions remain with your claims team.
Documents
Document types handled
Extraction
Data captured
- Policy number and claim number
- Claimant / patient name and ID
- Incident or admission date
- Hospital, garage or provider
- Treatment, damage or parts description
- Claimed amount and line items
- Vehicle plate and chassis number (motor)
Validation
Checks applied to every document
- Policy number matches across claim form and supporting documents
- Incident date falls within the policy period
- Required documents present for the claim type
- Bill or estimate total equals the sum of its lines
- Claimed amount compared against bill and estimate totals
- Identity details consistent with policy holder records
Workflow
End-to-end processing flow
- 1Claim bundle received
- 2Pages classified and grouped
- 3Fields extracted with confidence
- 4Claim context assembled
- 5Completeness and consistency checks
- 6Adjuster review of exceptions
- 7Validated file sent to claims system
Integration
Where the data goes
Security
Deployment and control
Outcomes
What changes for the business
Faster first touch
Claims arrive at the adjuster already classified, extracted and checked.
Earlier gap detection
Missing documents are identified at intake rather than mid-assessment.
Evidence on every value
Each extracted fact links back to the page it came from for audit.
Adjusters on judgement
Manual keying is reduced so specialists focus on assessment.
Outcomes describe the design intent of the solution. Actual results depend on document complexity, workflow design, integration requirements and deployment environment.
Frequently asked questions
Bring Insurance Claims Intelligence into straight-through processing
Book an enterprise demo and we will walk through your document types, validation rules and integration architecture.