Intelligent Document Processing for Insurance Claims

Intelligent Document Processing for Insurance Claims

“This solution eliminated the backlog overnight. Our adjusters finally have the bandwidth to focus on customers.”

VP of Operations, NDA

Overview

Overview

A regional property and casualty insurance provider was struggling with inefficient claims processing driven by manual document handling. With over 12,000 claims annually — each involving multiple files like police reports, medical records, repair estimates, and photos — adjusters were spending up to 75% of their time on data entry instead of investigation and communication.

Manual workflows created delays, increased errors, and often led to inconsistent customer experiences. Each claim took an average of 3 days just to process supporting documents, slowing settlements and frustrating both employees and policyholders.

Lunari implemented an intelligent document processing system that automated the extraction, validation, and routing of claim data. The result was a shift from slow, manual triage to streamlined, AI-assisted operations without compromising regulatory compliance.

Goals

Goals

The engagement focused on building a compliant and scalable system to:

  • Reduce document processing time from 3 days to under 8 hours per claim

  • Achieve 90%+ accuracy in automated data extraction across all document types

  • Free up 60% of adjusters’ time for investigation and customer communication

  • Process 50% more claims annually without increasing headcount

  • Reduce manual entry errors that delay settlements

  • Ensure audit-ready compliance and document traceability

  • Support future growth in both claim volume and document complexity

Strategy

Strategy

Lunari delivered the solution in three structured phases:

Document Mapping and Model Training

A dataset of over 1,000 anonymized claim documents was used to identify document types and data fields. OCR and field extraction models were trained and validated using real examples, including scanned forms, photos, and handwritten notes.

Workflow Integration and Automation

The system was integrated via API into the client’s claims management platform. Once documents were uploaded, the assistant extracted structured data such as claimant name, incident date, and policy number. Low-confidence fields were flagged for adjuster review. Batch uploads and smart routing logic ensured smooth handling during peak periods.

Compliance and Optimization

All document flows were mapped to retention policies and logged for audit purposes. Adjusters could correct outputs via a feedback mechanism, which informed periodic model updates managed through CI/CD pipelines.

The solution ran on secure cloud infrastructure with autoscaling enabled during high-volume periods like weather events.

Solutions implemented

Solutions implemented

Lunari delivered a secure, scalable system that automated document extraction, validation, and routing across the entire claims workflow. The implementation included four main components:

1. Document Intelligence Engine

  • OCR system capable of processing scanned PDFs, handwritten notes, and low-quality uploads

  • Auto-classification for over 30 document types, including police reports, repair estimates, medical records, and incident photos

  • Field-level extraction for key data points such as policy number, claimant name, damage amount, and incident date

  • Confidence scoring and flagging for human-in-the-loop review on low-certainty fields

2. Workflow Automation and Claims Integration

  • Real-time API integration with the client’s claims management system

  • Automatic population of structured data into existing workflows, eliminating 85% of manual entry

  • Smart routing of exceptions to specific teams (e.g. medical review, legal)

  • Batch document ingestion to support bulk uploads during seasonal volume spikes

3. Compliance and Data Security

  • End-to-end encryption of all documents in transit and at rest

  • Full audit logging from document intake to final decision

  • Built-in retention rules and data lifecycle management aligned with insurance regulations

  • Role-based access ensuring claim data is only visible to authorized personnel

4. Monitoring and Feedback Loop

  • Live dashboards showing accuracy rates, throughput, and document types processed

  • In-platform feedback mechanism for adjusters to correct fields and submit edge cases

  • Regular model tuning cycles based on real-world corrections, managed under controlled CI/CD pipelines

  • Elastic cloud infrastructure that scales automatically during claim surges (e.g., storm seasons)

The system enabled the client to process high document volumes without compromising data integrity or compliance, and without increasing operational headcount.

Results

Results

Within six months, the system exceeded performance targets and created measurable operational gains.

The system now handles 95% of claim documents autonomously, with human review only for edge cases. The insurer increased claim capacity by over 50% without expanding the claims team, while improving both employee and customer experience.

85%

reduction in document processing time – from 3 days to 8 hours on average

94%

accuracy in automated data extraction across all document types

620K

in annual operational savings, driven by reduced manual processing, faster cycle times, and fewer claim reworks

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