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Solutions / Agentic claims
Solution · UiPath Maestro

Insurance claims, fully agentic, on UiPath Maestro.

AI agents triage, assess and settle claims inside a BPMN process on UiPath Maestro. Fraud and authority rules run as business rules, and a claims officer holds authority on every exception.

At a glance
Used in:Financial Services & Insurance
IndustryInsurance
PlatformUiPath Maestro
ProofSimulation
Human authorityClaims officer on exceptions
70%+simple claims settled same day (from 20%)
45 minassessor time per complex claim (from 3 hours)
100%claims fully evidenced for audit

Design targets from the simulation, not client results; your assessment sets real targets.

See it run

Watch a claim settle itself.

A motor claim from first notice to payment on UiPath Maestro: agents read, check cover, score fraud and estimate, and an assessor makes the call.

Synthetic data. On a phone, tap the card to open it full screen. Open the demo page →

The problem.

Slow settlement

Claims wait between lodgement, assessment and payment teams.

Manual assessment

Assessors re-key data and read documents by hand.

Regulatory weight

General Insurance Code, CPS 230 and full decision evidence.

Solution architecture.

The reference architecture we build and run.

Channels
Claims portalContact centreBroker API
Orchestration
UiPath MaestroBPMN claims processBusiness rules
Agents
Document agentFraud triage agentAssessment agentUiPath AI Trust Layer
Systems
Policy adminClaims systemPaymentsDocument store
Run & evidence
Append-only audit logUiPath Insights24x7 operations

How it runs.

Each step, who does it, and the control that applies.

#StepWhoControl
1First notice of lossCustomer or brokerCase opened; SLA timer starts
2Documents read and classifiedDocument agentApproved tools only
3Fraud and identity triageFraud agent + robotAny flag goes to a person
4Coverage and assessmentAssessment agentLow confidence goes to a person
5Authority and settlement rulesBusiness rulesVersioned, replayable rules
6Exception or approvalClaims officerHuman authority on material decisions
7Payment and recordPayment robotEvery step on the audit log

Governed by design.

Five guardrails on every agent, plus the controls for this solution.

Blocked · CLM-07 A claim can’t be declined on fraud signals alone. A person reviews the evidence. Try it in the simulation.

ScopeA written job per agent
Human authorityPeople hold material decisions
PolicyRules enforced in the process
ReliabilityTested, monitored, rolled back
EvidenceEvery action on the record

Solution controls

  • Every agent action and robot step on an append-only log
  • Data held in Australian regions
  • Claims officer approves every exception and authority breach
  • Agents evaluated on masked data before promotion
  • Controls mapped to APRA CPS 230 and CPS 234

Proof.

Simulation · Insurance · UiPath Maestro

See a claim run on Maestro

A motor claim from first notice to payment, with agents doing the work and a claims officer on exceptions.

7process steps
3AI agents
1human decision point
Discuss the approach →

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Bring us one process. We'll show you it running.

A 45-minute briefing with an engineer, or a 1-week assessment that ends in a costed roadmap.