One long-horizon agent 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.
File intake to write-back — executed, with evidence.
Every stage below is one 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 agent.
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.