Kognify Autonomous Claims Handling

Claims that work themselves to a decision

Kognify runs the claim end to end. It takes the first notice of loss from any channel, corresponds with the claimant to gather every missing document, pulls the policy and prior history, recalculates the payout and matches it line by line against coverage and limits - then either settles within your rules or hands an adjuster a complete, decision-ready file. Your people touch only the claims that genuinely need them.

What do we solve? → Talk to us

~70%

Of claims handled end to end - straight-through settled or fully prepared without adjuster legwork

complete

Every handover is a decision-ready file - documents gathered, payout recalculated, coverage matched

100%

Coverage check and SLA clock on every claim - no leakage, no missed regulated deadline

FNOL from Email Web & app forms Letters & scans Call transcripts Broker submissions + PDF / photo evidence

The Problem

The claim arrives in a minute. Working it takes days.

A claim rarely lands complete. Someone reads the notice, writes back for the missing photo or invoice, waits, chases, looks up the policy, checks coverage and limits, recomputes the amount - then either settles it or writes up the file for an adjuster. That back-and-forth, multiplied across every channel and line of business, is where cycle time, leakage and customer goodwill disappear.

✕Most claims land incomplete - handlers email for documents and wait on the claimant to reply.

✕Every claim means pulling policy, endorsements and prior history from several systems by hand.

✕The payout is recomputed and matched against coverage and limits manually - the main source of leakage.

✕Simple, payable claims sit in the same queue as the complex ones, all waiting for an adjuster.

✕Regulated settlement clocks run the whole time - and the breach is found after the fact.

~70%

of handling time goes on correspondence, document-gathering and lookups - not on the actual claims decision.

days

Lost to back-and-forth as claims stall waiting on one missing document or photo from the claimant.

<30%

of claims genuinely need an adjuster's judgement - the rest are payable or just need the legwork done.

How It Works

Kognify works the claim the way a good adjuster would

Kognify takes the claim and runs it - it understands the loss, corresponds with the claimant to complete the file, pulls the policy and history, and assesses the payout against coverage. Only when an adjuster is genuinely required does it stop, and it hands over a file that's already done. Here is the path every claim takes:

01📥

Intake & understand

Takes the FNOL from any channel and works out what was lost, on which policy, and how serious it is.

▶

02💬

Correspond & complete

Replies to the claimant in your voice, requests the missing documents and photos, and chases until the file is whole.

▶

03🔗

Pull policy & history

Retrieves the policy, endorsements, prior claims and customer records from your systems and ties them to the claim.

▶

04🧮

Recalculate & match

Recomputes the payout bottom-up and matches it line by line against coverage, limits, deductibles and exclusions.

▶

05⚖️

Settle or hand over

Settles within the authority you set - or hands an adjuster a complete, decision-ready file with a recommendation.

▶

Outcome of step 05

🟢

Straight-through settledFile completed, coverage matched, payout within authority and within policy - settled and the claimant answered, no adjuster touch needed.

📋

Decision-ready handoverNeeds human judgement, exceeds authority, or a discrepancy / fraud signal fired - the adjuster gets the full file, the recalculation and a recommended next step. Nothing left to chase.

The Assessment Core

Where claims leak: the payout, recomputed and matched to the policy

Gathering documents is half the job - the other half is getting the number right. Kognify rebuilds the payout from the ground up and proves it against the policy, the same verification engine that recalculates and 3-way-matches invoices in our accounting operator, pointed at coverage instead of purchase orders.

Recalculate, don't trust

Every figure rebuilt bottom-up

Kognify doesn't take the claimed amount at face value. It reconstructs the loss from the evidence - line items, quantities, repair estimates, invoices - and recomputes the payable figure itself before anything moves.

Line-item extraction from invoices, estimates and reports
Payable amount recomputed independently of the claimed amount
Deductible, depreciation and limit applied per policy terms
Discrepancy and duplicate-claim signals raised, not waved through

Match against coverage

Claim ⇔ policy ⇔ limits, line by line

Each element of the claim is checked against what the policy actually covers - in force at the date of loss, within sub-limits, outside exclusions - with every result traced to the clause behind it.

Policy in force at date of lossCover dates ⇔ loss date

✓ Match

Damage within covered perilsPeril ⇔ policy schedule

✓ Match

Claimed amount vs. sub-limit€14,200 ⇔ €10,000 cap

! Over limit

Deductible applied€500 own-risk

✓ Applied

📝 Coverage, limits & settlement authority configured in plain language - no code, live in days

🔍 Every payout figure traced to the evidence line and the policy clause behind it

🔐 Azure EU · dedicated tenant · no client data trains public models

The Claim File

Whether it settles or hands over, the file arrives complete

Everything Kognify gathers, recomputes and decides becomes one orderly record. When an adjuster picks up a claim, there is nothing to reconstruct and nothing left to ask the claimant.

🏷️

The loss, understood

Cause and date of loss, line of business, policy and claimant matched, severity and a plain-language summary of what is being claimed.

💬

The complete evidence file

Every message exchanged with the claimant, the documents and photos requested and received, and the policy and prior-claims history pulled.

🧮

The recalculation & recommendation

The recomputed payout, the coverage and limit match, any discrepancy or fraud signal, and the settlement taken or the recommended next step.

🛡️ Fraud & duplicate-claim signals surfaced on every file

🔍 Full audit trail on every AI decision and figure

⏱️ Regulated settlement clock tracked per claim

Smart Features

Configured the way you'd brief a new adjuster.

No IT consultants, no deployment cycles. Business users define coverage logic, tone of voice, what to collect, settlement authority and when to hand over - in plain language, live immediately.

💬

Two-way correspondence

Replies to the claimant in your voice, requests the missing documents and photos and follows up - a real exchange, not a stock auto-reply.

🧮

Payout recalculation & matching

Rebuilds the payable figure bottom-up and matches it against coverage, limits, deductibles and exclusions - the leakage-control core.

🛡️

Fraud & discrepancy signals

Flags duplicate claims, inconsistent evidence and amounts that don't add up - routed to a person, never silently paid.

⚖️

Authority-bound settlement

Settles within the limits and authority you set. Anything outside them stops and goes to an adjuster - never invented.

⏱️

Deadline & SLA tracking

Starts the regulated settlement clock per claim, warns before breach, and keeps a full timeline for every claim.

🔌

Integrates with your stack

Core policy admin, claims and document systems. Webhook-driven hand-off into your existing claims workflow.

Proven in Production

Built on an engine already running in production.

Claims handling isn't built from scratch - it composes two capabilities already live in production for enterprise clients, backed by structured onboarding and support, not optimism.

💬

Layer 01 · Modular capability

Case & correspondence layer

The engine that runs a case end to end - multi-channel intake, two-way correspondence with the customer, data-gathering and orderly handover. Already in production behind our complaint handling, presales and support operators.

🧮

Layer 02 · Modular capability

Recalculate & match verification core

The engine that rebuilds a figure bottom-up and proves it line by line against a reference - recompute, 3-way match, flag discrepancies. Already in production behind our accounting operator, here pointed at coverage and limits.

99%+

Production success rate on document understanding across live clients

100%

Discrepancy detection - problems caught, not waved through

days

From signed contract to a working POC on your real claims

50%

Of clients expand into additional processes within 2 months

🔐 Azure EU · Dedicated Tenant Isolation

📋 GDPR · NIS2 · DORA · IDD aligned

🔍 Full audit trail on every AI decision

⏱️ <3-day issue resolution SLA

🚫 No client data trains public models

Client Voice

Serving some of the largest companies in Bulgaria.

The same understanding engine, already in production across finance, banking and regulated industries.

"As one of Bulgaria's leading courier companies, we process thousands of documents every month. With Kognify, in the very first month of deployment we achieved over 98% successfully processed documents - even while the system was still being tuned. The system independently identifies discrepancies and escalates only genuine exceptions. That gives us confidence without losing control."

Tsvetelina Lazarova

Manager, Projects & Relationships, Finance Group · Speedy AD

Also trusted by

Baumax

Minimart

VP Brands

Postbank

TBI Bank

Würth

Veolia · Sofia Water

Sofarma

🤝

Proud Technology Partner

of Konica Minolta Bulgaria

See it run on your own claims.

Send us a sample of real claims across your channels and we'll show you Kognify correspond, complete the file, recalculate the payout and match it to coverage - then either settle or produce the decision-ready handover, each figure traced to its source. Free POC in under 2 weeks, free first pilot in production in under a month.

Contact the team → kognify.ai

hey@kgnfy.com · +359 878 78 220 · kognify.ai