Long-horizon agentic AI runs QA on every claim and every risk.
The Layerup QA agent reviews claim files, estimates, and payments against your claims-handling guidelines, and underwriting files, pricing, and referrals against your underwriting standards — 100% coverage instead of thin samples, with evidence-linked findings and remediation driven to closure.
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.
One prompt in, one output out. The run is over in seconds — whatever state the work is in.
One workflow worked continuously, for hours or days, until it is actually finished.
Stateless per call. Everything learned about the case is forgotten between steps.
Persistent working memory of the whole case — every document, finding, and decision carried forward.
Guesses or stalls when an input is incomplete. Someone has to notice and re-prompt.
Requests the missing document, follows up, waits for it to land, and resumes exactly where it left off.
Returns a response. Acting on it — updating the core system, moving the queue — is still human work.
Reads from and writes back to your systems of record throughout the run, every action logged for audit.
A label, a draft, a score — an input to someone else's work.
Finished, decision-ready work with rationale and citations attached, staged for human approval.
A one-shot agent can score a single file against a rubric. It can't run the QA program — review the whole book instead of a thin sample, trace each finding to root cause with evidence, route remediation to the right owner, follow it to closure, and write results back. The long-horizon QA agent runs that full loop, file after file, until the review cycle is complete.
File intake to write-back — executed, with evidence.
Every stage below is the same agent's continuous run, from file intake and rubric match to remediation and write-back. Claims and underwriting QA leaders calibrate, approve, and own outcomes.
- 01File intake & sampling
- 02Guideline & rubric match
- 03Claim / underwriting file review
- 04Findings & scoring
- 05Remediation & coaching
- 06Write-back & reporting
Six stages. One governed continuous run.
Claims file QA, estimate and payment QA, underwriting file QA, pricing and referral QA, findings, remediation — the same QA agent executes every stage below in one continuous, governed run.
Review every claim file, not a 2% sample.
The QA agent reviews claim files against your claims-handling guidelines — coverage decisions, liability assessments, documentation completeness, and timeline compliance — and scores 100% of files instead of a thin sample.
- 01Coverage decision review
- 02Liability and evaluation checks
- 03Documentation completeness review
- 04Jurisdictional timeline compliance
- 05Full-coverage scoring, no sampling gaps
Catch leakage before it leaves the building.
The agent reviews estimates, reserves, and payments on every claim — line items against pricing guidelines, reserve support, payment accuracy, and missed subrogation or salvage — and flags leakage with citations to the file.
- 01Estimate review against pricing guidelines
- 02Payment accuracy verification
- 03Reserve adequacy checks
- 04Missed subrogation and salvage detection
- 05Leakage flagging with file citations
Review every risk the way your best underwriter would.
The agent reviews underwriting files end to end — risk assessment quality, guideline adherence, appetite fit, and documentation of the decision — and flags files that drift from your standards.
- 01Risk assessment quality review
- 02Underwriting guideline adherence
- 03Appetite and eligibility consistency
- 04Decision documentation checks
- 05Drift detection across the book
Keep rating and referrals on standard.
The agent verifies rating inputs and pricing against filed rates and rules, reviews referral packages for completeness, and confirms authority limits were respected on every bind.
- 01Rating input and pricing verification
- 02Filed rate and rule adherence
- 03Referral package completeness review
- 04Authority limit verification
- 05Premium leakage detection
Consistent scores, defensible findings.
Every finding carries a score, a rationale, and evidence links into the claim or underwriting file. The agent calibrates against your reviewers' decisions so scoring stays consistent across teams, sites, and time.
- 01Structured findings with rationale
- 02Evidence-linked scoring
- 03Reviewer calibration loops
- 04Trend and root-cause rollups
- 05Dispute-ready documentation
Close the loop, not just the review.
The agent routes defects to adjusters and underwriters, drafts coaching notes tied to specific files, tracks remediation to completion, verifies the fix on re-review, and writes results back into your systems.
- 01Defect routing to file owners
- 02Coaching notes tied to specific files
- 03Remediation tracking to closure
- 04Fix verification on re-review
- 05QA-system write-back and reporting
The metrics claims and underwriting QA leaders manage.
Layerup is measured on review coverage, defect detection, leakage reduction, guideline adherence, and remediation turnaround — not on tokens, prompts, or messages.
Review coverage rate
01Score every claim and underwriting file, not a thin sample.
Claims leakage reduction
02Catch estimate, payment, and recovery misses per file.
Payment accuracy
03Verify every payment against coverage and guidelines.
Guideline adherence
04Apply claims and underwriting standards uniformly.
Appetite & pricing consistency
05Keep rating and risk selection on filed standards.
Defect detection rate
06Surface more errors and misses per review.
Calibration consistency
07Score the same way across teams, sites, and time.
Remediation turnaround
08Close findings and verify fixes within SLA.
Cost per review
09Lower handling cost across QA queues.
Move QA from sampling to full coverage.
Deploy the QA agent on one review queue — claims file QA, estimate QA, or underwriting file QA. Prove the coverage and leakage-detection lift, then expand.