Insurance Claims Automation
In development · expected Q3 2026
Every claim read, classifiedand routed automatically.
Pegasus reads every incoming claim, classifies it, checks it against coverage and routing rules, and sends routine claims through automatically while adjusters handle the ones that need judgment.
- No claims-system migration
- Adjusters keep every decision
- Explainable routing with an audit trail
Claims intake — Tuesday, 493 new claims
- claims received
- 493
- routine
- 412
- review
- 64
- urgent
- 17
- Urgent
CLM-88213 · Water damage, residential
Policyholder reports an active leak and displacement; photos attached.
- Urgent
CLM-88240 · Auto collision, injury reported
A third-party injury is mentioned in the description.
- Review
CLM-88225 · Theft, commercial property
The claimed amount is 3× the average for this policy class.
Sample data. Every finding shows what was found, why it was flagged, the evidence, and what a person decides.
Claims processing shouldn't start with someone re-reading every form.
Manual first read
Every first notice of loss is opened, read and categorized by a person before anything happens.
Rekeying between systems
Claim details are typed from the form into the claims system, then into the document system.
Urgent claims wait in the queue
A displaced family's claim sits behind a windshield replacement until someone reads both.
Pegasus reads, classifies and routes every claim, and adjusters decide the ones that matter.
How Pegasus works
- 01
Connect
Pegasus connects to the systems where the work already happens.
Pegasus connects to your claims platform, policy administration system, document management and the channels where claims arrive.
- 02
Process
Rules and AI perform the repetitive workflow.
Every first notice of loss is read, classified, checked against coverage and routing rules, and routine claims are moved to the right lane automatically.
- 03
Review
Humans see only exceptions, risks and decisions.
Adjusters and supervisors see only the claims that need judgment, with the reason and the evidence attached, and every routing decision is logged.
AI does the volume. Humans keep the judgment.
Interactive sample
Here is the finding. Here is the evidence. You decide.
Click any finding. Every one answers what Pegasus found, what your rule says, why it was flagged and where the evidence is, then leaves the decision with you. This is the workflow the agent is being built to run.
Claims intake — Tuesday, 493 new claims
- 493 claims received
- 412 routine
- 64 review
- 17 urgent
CLM-88213 · Water damage, residential
Urgent- Found
- Policyholder reports an active leak and displacement; photos attached.
- Routing rule
- Habitability claims route to the rapid-response desk within 2 hours.
- Reason flagged
- Displacement flagged in the first notice of loss.
- Source
- FNOL form · 3 photos · policy HO-4471
Your decision
Pegasus proposes. You decide, and the decision is logged with your name, the time and the evidence.
Keep the systems you already use.
Pegasus operates across your workflow instead of forcing another platform migration.
- Guidewire
- Duck Creek
- Salesforce
- Microsoft 365
- SharePoint
Your claims system stays the system of record. Pegasus reads, classifies and writes the routing decision back.
Pilot list
Join the Insurance Agent pilot list
The Insurance Agent is in development, expected Q3 2026. Pilot-list members get the first pilot slots and a walkthrough of the workflow on one of their own examples as it ships.
- First access when pilots open
- A walkthrough of the workflow on your own example
- No commitment, and a say in what it handles first
Join the pilot list
First access when pilots open. Nothing to install, nothing to commit to.
FAQ
Insurance Claims Automation FAQs
Next step
Join the Insurance Agent pilot list
No commitment. We email when pilots open, with a walkthrough on your own example.