AI-Powered Claims Triage & Automation for Multi-Jurisdiction MGA
The Challenge
A UK-regulated MGA with operations across three jurisdictions was processing claims manually — slow, error-prone, and unable to scale. A backlog of 3,000+ claims was creating regulatory exposure and deteriorating broker relationships.
AI Triage Layer
LLM-powered document parsing and classification — routing claims to the correct team in under 30 seconds from submission.
Automated Coverage Check
Rules engine cross-referenced against policy wording to auto-approve or flag borderline claims for human review.
Compliance Audit Trail
Every decision logged with reasoning, timestamp, and handler — FCA-ready audit trail generated automatically.
Dashboard & Reporting
Real-time claims dashboard with SLA tracking, outstanding exposure view, and one-click regulatory reporting.
Outcome
The 3,000-claim backlog cleared in 11 days. Processing time dropped from 4.2 days average to under 6 hours. The MGA renewed its broker panel 100% intact at next cycle — a first in three years.