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AI Agents / Claims

Long-horizon agentic AI runs the entire claim.

The Layerup claims agent intakes the claim, verifies coverage, flags fraud and subrogation, prepares the file, supports reserves, and delivers adjuster-ready output — not a one-shot pass, but a continuous run that works the file uninterrupted for hours or days until it is finished.

ScopeIntake to write-back
CoveragePersonal & commercial
AdoptionOne workflow, one team
01One-shot vs long-horizon

One-shot agents answer. Long-horizon agents finish.

Most AI agents are one-shot: one prompt, one response, no memory, no obligation to finish. Layerup agents are long-horizon — each owns a workflow end to end and stays on it, uninterrupted, for hours or days until the work is done.

Span
One-shot

One prompt in, one output out. The run is over in seconds — whatever state the work is in.

Long-horizon

One workflow worked continuously, for hours or days, until it is actually finished.

State
One-shot

Stateless per call. Everything learned about the case is forgotten between steps.

Long-horizon

Persistent working memory of the whole case — every document, finding, and decision carried forward.

Missing evidence
One-shot

Guesses or stalls when an input is incomplete. Someone has to notice and re-prompt.

Long-horizon

Requests the missing document, follows up, waits for it to land, and resumes exactly where it left off.

Systems
One-shot

Returns a response. Acting on it — updating the core system, moving the queue — is still human work.

Long-horizon

Reads from and writes back to your systems of record throughout the run, every action logged for audit.

Output
One-shot

A label, a draft, a score — an input to someone else's work.

Long-horizon

Finished, decision-ready work with rationale and citations attached, staged for human approval.

In this workflow

A one-shot agent can classify the FNOL or score severity — then the run is over, and the claim isn't. It can't wait three days for the police report, reconcile it against the estimate when it lands, re-score severity after the supplement, or keep the file adjuster-ready as evidence arrives. The long-horizon claims agent does all of that in a single run, from intake to write-back.

02Lifecycle

The full claims lifecycle, executed in one continuous run.

Every stage below is the same agent's single continuous run, from intake to write-back. Adjusters and examiners approve, supervise exceptions, and own outcomes.

Claims lifecycle
7 stages
  1. 01
    FNOL / Intake
  2. 02
    Coverage verification
  3. 03
    Triage & severity
  4. 04
    Fraud & subrogation flagging
  5. 05
    File readiness
  6. 06
    Reserve support
  7. 07
    Adjuster handoff & write-back
03Cross-LOB

A dedicated claims agent for every line of business.

Each line of business gets a dedicated claims agent that executes every step below in a single run — beyond triage, scoring, and recommendations, it works the workflow, prepares the file, and delivers the result.

Auto

01

Personal and commercial auto.

  • FNOL / intake
  • Coverage verification
  • Fraud flagging
  • Subrogation detection
  • Estimate QA
  • Settlement support

Property

02

Homeowners, dwelling, and commercial property.

  • Email intake
  • Contents valuation
  • Estimate QA
  • Invoice QA
  • Restoration review
  • Payout support

Commercial

03

GL, BOP, package, and middle-market lines.

  • FNOL / intake
  • Coverage verification
  • Document ingestion
  • Fraud and subrogation flagging
  • Reserve support
  • Examiner handoff package

Workers' Comp

04

Statutory workers' compensation.

  • FROI intake
  • Injury data capture
  • Jurisdiction deadline support
  • Compensability review support
  • Medical record summarization
  • Return-to-work signals
  • Reserve support
  • Litigation / denial package

Cyber

05

Cyber liability and tech E&O.

  • Incident intake
  • Vendor / forensics document ingestion
  • Coverage verification
  • Severity and exposure summarization
  • Reserve support
  • Examiner handoff package

IDI / Specialty / E&S

06

Individual disability, specialty, and E&S programs.

  • Claim intake
  • Document ingestion
  • Medical / financial record summarization
  • Coverage and benefit verification
  • File readiness
  • Examiner handoff package

Mortgage Insurance

07

Private mortgage insurance claims and underwriting.

  • Delinquency / claim intake
  • Servicer document ingestion
  • Coverage and certificate verification
  • Loss mitigation review support
  • Claim calculation and perfection
  • Payout preparation
04Auto & Property

Estimate-driven, physical-damage execution.

Auto and property claims demand precise estimate review, contents valuation, and vendor coordination. The claims agent handles the operational mechanics end to end.

04 — Auto & Property
7 steps

Estimates, invoices, contents, payouts.

The claims agent reviews estimates and invoices for line-item accuracy, values contents from documentation, supports repair and restoration review, and prepares settlement packages for human approval — all within the same run that opened the file.

  • 01Estimate QA
  • 02Invoice QA
  • 03Contents valuation
  • 04Repair / restoration review
  • 05Payout / settlement support
  • 06Supplement handling
  • 07Vendor coordination support
05Fraud & subrogation

Flag fraud. Detect subrogation. Prepare the file. Deliver the result.

Throughout its run, the claims agent continuously evaluates intake, documents, and emerging file evidence for fraud signals and recoverable exposure — and prepares the package, not just the alert.

05A — Fraud detection
5 steps

From signal to packet.

The claims agent synthesizes intake, documents, prior history, and behavioral signals to flag fraud and prepare a referral packet for SIU.

  • 01Continuous fraud signal detection
  • 02Document and statement consistency review
  • 03Inconsistency, repetition, and pattern flags
  • 04Referral package for SIU
  • 05Reasoning trace for every flag
05B — Subrogation detection
5 steps

Recoveries that no longer slip.

The same agent identifies recoverable exposure across the file, prepares evidence, and stages the next step in the recovery workflow — no handoff, no second system.

  • 01Liability and party identification
  • 02Subrogation indicator detection across documents
  • 03Evidence assembly for recovery
  • 04Demand-package preparation support
  • 05Status tracking inside existing systems
06File readiness

Adjuster-ready files prepared by the agent, not humans.

The claims agent continuously assembles the file — coverage, parties, documents, summaries, exposures, and decision inputs — so that human review is a final approval, not a manual build.

06 — File readiness
5 steps

Approval-ready packages, end to end.

Across its run, the agent ingests documents and email, extracts data, summarizes findings, and assembles adjuster-ready packages that move the file from queue to closure.

  • 01Document ingestion and classification
  • 02Data extraction across the file
  • 03Summarization of key facts
  • 04Exposure and reserve inputs prepared
  • 05Decision package staged for approval
07KPIs

The metrics claims executives manage.

Layerup is measured on cycle time, file readiness, leakage, recovery capture, and SLA attainment — not on tokens, prompts, or messages.

Cycle time

01

Compress days into hours across intake to closure.

Claim closure time

02

Drive faster, higher-quality file completion.

File readiness

03

Adjuster-ready files prepared by the agent, not humans.

Adjuster productivity

04

Increase files per FTE without growing headcount.

Cost per claim

05

Reduce manual handling and BPO escalation.

LAE reduction

06

Lower loss adjustment expense across the lifecycle.

Loss ratio improvement

07

Tighter coverage, fraud, and reserve decisions.

Leakage reduction

08

Catch missed exposures, recoveries, and pay-without-cause errors.

Fraud detection yield

09

Surface higher-confidence fraud signals at intake.

Subrogation recovery capture

10

Identify and prepare recoverable files automatically.

Reserve accuracy

11

Support timely, evidence-based reserve posting.

SLA attainment

12

Meet jurisdictional and contractual deadlines.

Get started

Move claims work from doing to approving.

Start with one line of business. Deploy its claims agent, prove the KPI improvement, and expand.