Settling straightforward travel claims faster while focusing experts on risk
About the Customer
This customer is a major insurer offering travel, health, motor, and personal lines products across a large consumer customer base. The organization processes significant travel claim volumes each year while balancing customer experience, operational efficiency, and fraud management requirements.
Summary
The customer wanted to improve travel claim efficiency without weakening controls. While many claims were straightforward and low value, every claim still required review effort, creating delays for customers and operational costs for the insurer.
Kamios introduced a verification-first claims workflow that validates external events, assesses supporting documentation, and routes only higher-risk cases to assessors. This allowed straightforward claims to move through the process quickly while ensuring potentially suspicious claims received appropriate attention.
The Challenge
The insurer wanted to improve travel claims efficiency while maintaining strong fraud controls. Although many claims were straightforward and low value, they still required review effort, creating operational costs and delaying outcomes for genuine customers. This resulted in:
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01
Handling Costs
High manual handling costs
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02
Low-Risk Volume
Large volumes of low-risk claims requiring review
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03
Slow Processing
Slow processing of straightforward claims
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04
Communication
Inconsistent communication with claimants
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05
Balancing Pressure
Ongoing pressure to balance efficiency with fraud controls
The Kamios Approach
Kamios introduced a verification-first claims process that prioritizes external validation before deeper investigation. The platform evaluates claims using multiple coordinated capabilities and routes exceptions automatically.
External Verification
Confirmed travel disruptions using independent data sources.
Claim Categorization
Classified claims and extracted relevant information.
Document Analysis
Identified inconsistencies and authenticity concerns.
Abnormality Detection
Highlighted unusual claimant behavior and patterns.
Customer Communication
Generated targeted requests for missing information.
Settlement Orchestration
Processed eligible claims and escalated exceptions.
Business Impact
The key transformation was shifting assessment effort toward the claims most likely to benefit from human review.
Straightforward claims no longer waited behind investigations that were unlikely to uncover meaningful issues. Assessors gained access to clearer evidence and more focused review populations, while customers experienced faster responses and improved communication throughout the claims process.
Outcomes
- More straightforward claims were resolved without manual intervention.
- Assessor effort was focused on higher-risk cases.
- Processing times for genuine claims improved.
- Customer communications became more consistent.
- Fraud controls were maintained while efficiency increased.
Who is Kamios?
Kamios is the AI agent orchestration platform purpose-built for Insurance and regulated industries: one governed place for insurers, banks and financial services firms to run AI agents on live cases, from claims and underwriting to onboarding and credit decisions, with every action declared, evidenced and metered. A Neutrinos business, built by founders with decades in insurance and banking technology.