Risk & Claims
Claims Leakage (Tacita)
Find the money lost between claim notification and settlement.
01 / The problem
The problem.
Leakage hides in the steps between notification and settlement. It is rarely visible in any single claim, only in the pattern.
02 / What it does
What the agent does.
- Reviews claims against your handling process
- Flags steps where leakage typically occurs
- Captures expert adjuster judgment as candidate rules
- Routes findings to a person for decision
03 / How it is built
Built on ContextLab.
Ontology
Claim, policy, coverage, party
Process
Claims handling workflow
Formal Knowledge
Coverage rules and settlement guidelines
Tacit Capture
Adjuster overrides with reasons
AI Technologies
Anomaly detection · Language models · Document understanding
04 / Results
Typical KPIs we measure.
- Leakage identified per claim
- Adjuster time per claim
05 / Integration
Integrations and deployment.
Claims system · Document management
On-premise or private EU cloud
Related agents
More in Risk & Claims.
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