AI that scores fraud by
line of business, not by keyword
10 Knowledge Workers engineered for insurance operations — from FNOL intake through reserve adequacy, underwriting triage through actuarial filing. They understand your book of business because they were built around it.
What These Agents
Actually Do
Claims Review & Coverage Determination
Structured coverage analysis from insuring agreement through limits and deductibles. Policy interpretation applying plain meaning, ambiguity resolution, and reasonable expectations doctrine. Jurisdiction-aware fault analysis and individual case reserve methodology with subrogation offsets.
Fraud Detection & Investigation
Contextual fraud scoring where the same indicator is weighed differently by claim type. Network analysis to detect organized fraud rings across shared identities. Line-of-business-specific detection for auto, property, workers' comp, health, life, and liability claims.
Underwriting & Risk Assessment
Five-component risk analysis covering operations, hazards, loss history, management controls, and account characteristics. Four-tier submission triage from 24-hour priority to decline. Pricing through ISO/NCCI classification with experience modification and schedule rating.
Actuarial Modeling & Reporting
Multi-method loss reserving (chain ladder, Bornhuetter-Ferguson, Cape Cod, stochastic) with reserve ranges and confidence intervals. All work meets ASOP standards. Rate development with credibility weighting and filing documentation targeting >95% first-submission approval.
Policy Administration & Compliance
Premium rating across ISO rules, NCCI classifications, experience mods, and territory factors at 99.9% calculation precision. Multi-jurisdiction regulatory compliance covering state-approved forms, filing requirements, and coverage mandates.
How the Insurance Agents
Are Built Differently
Claims Vocabulary
That's Actually Granular
The insurance RAG profile uses smaller chunks (640 tokens) optimized for policy forms and tabular actuarial data. Query expansion understands that claim, loss, and incident are related — and that premium, rate, and pricing overlap but aren't identical. Preferred sources are insurance-specific: policy documents, claims data, underwriting guidelines, actuarial tables, loss run reports, reinsurance treaties, regulatory filings, and fraud indicators.
Authority Hierarchy
for Insurance
State insurance regulations and NAIC model laws are treated as binding authority. ISO forms are authoritative. Actuarial tables are authoritative with statistical confidence requirements. Claims history is evidential. Industry benchmarks are reference-level. This hierarchy ensures that when an agent produces a coverage determination, it's reasoning from the right sources at the right confidence level.
Guardrails Built
for Insurance
No claim can be denied without investigation — strict enforcement. All denials must be explained in writing. The system cannot guarantee claim approval, commit to settlements beyond authority limits, or disclose SIU investigations to claimants. Unfair Claims Practices Act compliance enforced. Human review required for: claim denials over $50K, coverage disputes, bad faith allegations, SIU referrals, catastrophe settlements, and reinsurance notifications.
Your Insurance Team
10 Specialized Knowledge Workers
Cy Claims Review & Processing Agent
Coverage determination, reserves, and settlement. 7-step coverage analysis · Jurisdiction-aware comparative fault · Reserve methodology (Individual Case Basis) · Settlement authority framework.
AI Knowledge Worker
Cy Underwriting Research & Ops Agent
Risk assessment, pricing, and submission triage. 5-component risk analysis · ISO/NCCI classification · Experience modification · Loss history trending · 4-tier triage.
AI Knowledge Worker
Cy Policy Review & Documentation Agent
Rating accuracy and regulatory compliance. Premium calculation (99.9% precision) · Multi-jurisdiction form compliance · ACORD/AL3 export · Endorsement management.
AI Knowledge Worker
Cy Fraud Insights & Investigation Agent
Detection, scoring, and SIU referral. Contextual fraud scoring · Network/ring analysis · Provider peer benchmarking · LOB-specific protocols (Auto/Property/WC/Health/Life/Liability).
AI Knowledge Worker
Cy Actuarial Modeling & Reporting Agent
Reserving, rate development, and regulatory filing. Chain ladder · Bornhuetter-Ferguson · Cape Cod · ASOP compliance · Reserve ranges with confidence intervals · >95% filing approval.
AI Knowledge Worker
Cy Insurance Risk & Filing Agent
State filing submissions and compliance tracking. Filing preparation · Approval status tracking · Compliance calendar management · Prior-approval vs. file-and-use state rules.
AI Knowledge Worker
Cy Claims Analytics & Predictive Insights Agent
Trend analysis and loss development forecasting. Loss development pattern analysis · Cost containment identification · Predictive modeling · Severity/frequency trending.
AI Knowledge Worker
Cy Coverage Advisory & Client Support Agent
Coverage comparison and client recommendations. Coverage option analysis · Policy alternative comparison · Client recommendation summaries · Gap identification.
AI Knowledge Worker
Cy Reinsurance Research & Ops Agent
Treaty analysis and cession management. Treaty structure analysis · Ceded premium tracking · Bordereaux report preparation · Reinsurance notification workflows.
AI Knowledge Worker
Cy Policy Renewal & Lifecycle Management Agent
Renewal management and retention analysis. Renewal timeline tracking · Retention analysis · Renewal quote comparison · Lifecycle documentation.
AI Knowledge Worker
Specialized for Insurance
Faster claims. Smarter underwriting. Your AI team processes applications, detects patterns, and ensures compliance—with the precision and consistency your business demands.