Automate actuarial premium adjustments and claims reporting with GPT-4.1, Gmail and Slack

How It Works

This workflow automates insurance claims processing by deploying specialized AI agents to analyze actuarial data, draft claim memos, and perform risk assessments. Designed for insurance adjusters, underwriters, and claims managers handling high claim volumes, it solves the bottleneck of manual claim review that delays settlements and increases operational costs. The system ingests new claims data via scheduled triggers, then routes information to an actuarial analysis agent that calculates loss ratios and risk scores. A memo writer agent generates detailed claim summaries with recommendations, while a risk assessment agent evaluates fraud indicators and coverage implications. An orchestrator agent coordinates these specialists, ensuring consistent analysis standards. Final reports are automatically distributed via email to product teams and Slack notifications to risk management, creating transparent workflows while reducing claim processing time from days to hours with standardized, comprehensive evaluations.

Setup Steps

1. Configure claims database API credentials in "Fetch New Claims Data" node
2. Input NVIDIA API key for all OpenAI Model nodes
3. Add OpenAI API key in Orchestrator Agent configuration
4. Set up Calculator Tool parameters for premium adjustment calculations
5. Configure Gmail credentials and recipient addresses for product team
6. Connect Slack workspace and specify risk team channel for alerts

Prerequisites

NVIDIA API access, OpenAI API key, claims management system API

Use Cases

Auto insurance claim triage, property damage assessment automation

Customization

Adjust risk scoring thresholds, add industry-specific analysis criteria

Benefits

Reduces claim processing time by 85%, ensures consistent evaluation standards