First notice of loss, structured at intake
A claim arrives as a phone call, an email, an app upload — rarely complete, never structured. This reference solution reads whatever comes in, extracts the facts, classifies the claim, checks it against what that claim type requires, and flags fast-track versus investigate. Adjudication then starts from a clean, cited record instead of a transcription queue.
What it does at intake
Fact extraction
Pulls the who/what/when/where from unstructured reports and normalises them into the claim schema for that line of business.
Completeness check
Flags what’s missing for that claim type — documents, declarations, photos — so the claim isn’t stalled mid-adjudication for want of a field.
Classification
Determines line and loss type, routing the claim to the right downstream queue and policy set.
Triage flag
Recommends fast-track for clean low-value claims and investigate for the ones with fraud or complexity signals — with the reasoning cited.
Claims FNOL FAQ
What is FNOL and why automate the intake?
First Notice of Loss is the moment a claim is first reported — by phone, email, app, or form, often incomplete and unstructured. Automating intake turns that mess into a structured, classified, completeness-checked claim record, so downstream adjudication starts from clean data instead of a transcription backlog.
What does the agent produce?
A structured claim: line of business, loss type, key facts extracted, a completeness check against what that claim type requires, and a triage flag — fast-track, standard, or investigate — each grounded in the policy and claim rules it applied.
Which lines does it support?
Designed for general insurance lines — motor, health, property, travel. Each line has its own intake schema and completeness rules; the same engine is pointed at the line’s specific policy and documentation.
How does it stay compliant and auditable?
Every intake decision writes an immutable record linking the inputs read, the classification logic, and the triage rationale. The design targets IRDAI’s audit and oversight expectations; final compliance is the insurer’s determination, and Vihaya is pre-revenue with no completed insurer pilot.
Want to see this in your environment?
30-minute discovery call. We follow up with a draft SOW shortly after.
Talk to us about a pilot