We deployed a multi-agent claims processing system over 16 weeks: Agent architecture (weeks 1-6): 7 specialised agents coordinated by an orchestration engine. Document Processing Agent: AI-powered document analysis. When claim documents arrive (email, WhatsApp, portal upload), the agent: classifies the document type (accident report, police report, medical bill, repair estimate, photo evidence), extracts structured data (claim amounts, dates, parties involved, vehicle details, injury descriptions), validates completeness (checking whether all required documents for the claim type are present — motor claims requiring accident report + photos + repair estimate at minimum), and flags quality issues (blurry photos, incomplete forms, missing pages). OCR accuracy: 95%+ on printed documents, 88% on handwritten (Singapore accident reports often partially handwritten). Processing time: 30 seconds per document (vs 15 minutes manual). Coverage Verification Agent: instantly checking the claim against policy terms.
When triggered by the orchestrator, the agent: verifies the policy is active (premium paid, no lapse), confirms the incident type is covered (checking policy schedule, endorsements, and exclusions), identifies the applicable excess/deductible (standard excess, voluntary excess, named driver excess), calculates the maximum claimable amount (sum insured minus previous claims in the policy period), and flags any coverage concerns (late notification, excluded drivers, excluded territories). Processing time: 2 seconds (vs 30 minutes manual — adjusters previously reading through policy documents to verify coverage). Fraud Detection Agent: pattern-based fraud screening.
Every claim automatically screened for: claim frequency (multiple claims from the same policyholder, address, or vehicle in a short period), timing patterns (claims filed immediately before or after policy changes — common in staged claims), amount patterns (claims consistently just below the threshold requiring additional documentation or approval), network analysis (connections between claimants, repair shops, medical providers, and witnesses — identifying fraud rings), and document anomalies (metadata analysis of photos — creation date, device, GPS location compared to claimed accident details). Risk scoring: each claim scored Low (0-30), Medium (31-60), High (61-80), or Critical (81-100). Low-risk claims: proceed without delay. Medium: flagged for adjuster awareness. High/Critical: referred to the fraud investigation unit with detailed analysis. Assessment Agent: calculating claim amounts for straightforward claims.
For motor claims: repair cost assessment using a database of standard repair costs by vehicle make/model/year and damage type — the agent comparing the submitted repair estimate against market rates and flagging significant deviations. For travel claims: flight delay compensation calculated automatically from flight data (FlightAware API), medical expense assessment based on submitted bills with standard rate comparison, and lost baggage compensation per policy terms. For simple property claims: damage assessment based on submitted photos and descriptions, compared against standard repair/replacement costs. The assessment agent handling "simple" claims end-to-end — the approximately 40% of claims that are straightforward with clear coverage, reasonable amounts, and no fraud indicators. Complex claims: routed to human adjusters with the agent's preliminary assessment as a starting point. Approval Agent: automated approval routing. Claims within the assessment agent's confidence threshold and below SGD 5,000: auto-approved (with audit logging).
Claims SGD 5,000-25,000: routed to senior adjuster with agent assessment and recommendation. Claims above SGD 25,000: routed to claims manager. The approval agent: tracking approval status, sending reminders for pending approvals, and escalating if approvals exceed SLA. Communication Agent: proactive customer updates. WhatsApp integration: the customer receiving automated updates at every milestone — "Your claim CL-2026-78432 has been received. We have your accident report and photos. We still need the repair estimate from the workshop — please submit when available." When documents are missing: specific, clear requests — not generic "please submit outstanding documents" but "We need the repair estimate from the workshop. You can take a photo and send it here on WhatsApp." Status enquiries: the customer asking "What's happening with my claim?" and receiving an immediate, accurate status update — no waiting for a call centre agent to look up the information.
Payment Agent: processing approved claim payments. Bank transfer via FAST for immediate payment (small claims under SGD 1,000 — paid within hours of approval). GIRO for larger amounts. Direct payment to repair shops and medical providers where the policyholder has authorised. Payment confirmation sent to the customer via WhatsApp. Orchestration Engine: coordinating all agents through the claims lifecycle. When a new claim is filed, the orchestrator launches parallel processing: Document Processing Agent starts immediately on submitted documents. Coverage Verification Agent runs simultaneously (using claim notification data — doesn't need full documents). Fraud Detection Agent begins screening with available data (enhanced as documents are processed). As each agent completes, the orchestrator evaluates: all documents received + coverage verified + fraud score low → trigger Assessment Agent. Assessment complete + amount within auto-approval threshold → trigger Approval Agent (auto-approve).
Approval complete → trigger Payment Agent + Communication Agent (payment initiated + customer notified). The entire flow for a simple claim: potentially completing in hours rather than weeks.