Giving advisors instant answers at the moment customers need them
About the Customer
This customer is a leading life insurer serving millions of policyholders through an extensive advisor network. The organization offers a broad range of protection, health, and life insurance products and manages a high volume of claims interactions across multiple markets.
Summary
The customer wanted to improve the claims experience at the very first point of interaction. Advisors frequently needed to answer coverage questions without immediate access to policy expertise, often resulting in incomplete submissions and delayed claim registration.
Kamios introduced an advisor copilot that provides coverage guidance, document validation, and claim registration support in real time. Advisors can now guide customers through the process with greater confidence while ensuring claims are complete before submission.
The Challenge
The insurer wanted to improve the claims experience at the first point of customer interaction. Advisors were expected to answer coverage questions, guide customers through requirements, and register claims accurately, but often lacked immediate access to policy expertise. This created delays for customers and increased rework for claims teams downstream. This resulted in:
-
01
Incomplete Submissions
Incomplete or incorrect claim submissions
-
02
Document Rounds
Multiple rounds of document collection
-
03
Registration Delays
Delays in claim registration and coverage verification
-
04
Rework
Rework caused by missing information
-
05
Inconsistency
Inconsistent customer experiences across advisor channels
The Kamios Approach
Kamios introduced an advisor copilot that supports claims conversations from initial inquiry through claim registration. The solution combined:
Coverage Intelligence
Retrieved relevant policy wording, benefits, and coverage conditions.
Clause-Based Guidance
Provided plain-language explanations supported by policy references.
Document Validation
Identified missing, incomplete, or illegible documents in real time.
Claim Completeness Assessment
Confirmed whether submission requirements had been met.
Claim Registration Automation
Structured and registered complete claims automatically.
Interaction Traceability
Maintained a record of guidance and policy references provided.
Business Impact
The most important change was moving coverage intelligence closer to the customer.
Advisors no longer needed to rely on memory or wait for support from head office before guiding customers through a claim. As submission quality improved, claims teams spent less time correcting or completing files. More claims entered the process ready for downstream handling, improving both operational efficiency and customer experience.
Outcomes
- Claim submissions became more complete and accurate.
- Advisors gained faster access to coverage guidance.
- Rework caused by missing information was reduced.
- More claims became eligible for straight-through processing.
- Customers received faster and more consistent service.
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.