Autonomous agents for insurance claims

Built to resolve insuranceclaims

MAVALLI puts a purpose-built AI agent on every repetitive task in a claim: the intake, the status call, the outreach and the file. Your adjusters keep the work that actually needs judgment.

Meet the agents See the platform

Lines of business Workers' compensation, property and casualty, health

Built for Carriers, third-party administrators, self-insured employers and their partners

Footprint Claims teams across the United States and Europe

Company Venture-backed, built by a team with machine learning research backgrounds

01 / The thesis

Claims work happens on three surfaces.

The phone, the inbox and the file. Everything else in a claim is a decision.

The phone

Status traffic is the single largest draw on a claims team's day. Claimants want to know whether a check has gone out, employers want to know what is owed, providers want to know whether a treatment was authorized. Each call is short, each call is predictable, and each call interrupts an adjuster mid file.

Outbound is worse, because it is the work that quietly does not happen. Wage statements, records requests and follow-up calls sit at the bottom of a worklist while the claim ages around them.

The inbox

A single claim can generate correspondence from five or six parties, arriving as replies to replies, with the detail that matters buried in an attachment. Someone has to read all of it, decide what is new, and put the new part somewhere the rest of the team will find it.

That reading is not judgment. It is transcription, and it consumes the hours that judgment needed.

The file

By the time a claim is contested, the file holds hundreds of pages across medical records, correspondence, forms, invoices and notes, written by people who never expected them to be read together. The answer to most questions is already in there.

Finding it is a research task. Adjusters do it under time pressure, in a system that was built to store documents rather than to read them.

Automation should take the typing, not the judgment.

The decisions in a claim are the part that requires a licensed, accountable human being: compensability, reserves, settlement authority, what a medical opinion is worth. We do not automate any of them, and we do not want to.

Everything leading up to those decisions is retrieval, data entry, correspondence and chase. That is the work MAVALLI takes. An adjuster whose morning is not spent on hold or re-keying a PDF is an adjuster who gets to the decision sooner, with a more complete picture in front of them.

02 / The agents

Four agents, each with one job.

Every agent owns a single high volume task end to end, which is why each one can be held to a standard.

Agent 01

Intake

Captures first notice of loss by phone, email or file upload, structures it and opens the claim in your system with no manual data entry.

Phone, email and upload in one agent
Complete before an adjuster sees it

Agent 02

Status

Answers inbound status requests in real time with the whole file in context, so a routine update never needs an adjuster or a hold queue.

Full claim context on every call
Operates in more than one language

Agent 03

Outreach

Works the phone outbound to employers, providers and injured parties, then logs every outcome back to the claim as it goes.

Persistent follow-up without chase lists
Every response written to the file

Agent 04

Assist

Sits beside the adjuster: retrieves facts from across the file, cites a source for each one, and recommends the next action.

Grounded answers with citations
Recommends, never decides

Read how each agent works

03 / The platform

One claim, four stages, one context.

The agents are not four products stitched together. They read and write the same claim context, which is what keeps a caller from being told something the file contradicts.

Stage 01

Capture

A loss arrives by phone, email or upload. The capture layer takes it in whatever form it comes, including voicemail and scanned paper.

Stage 02

Intake

Details are extracted, validated against your schema, and written into the claims-management system as a filed claim rather than a task to key in.

Stage 03

Engage

Inbound status is answered, outbound contact is made, and correspondence is parsed, structured and routed while the claim is open.

Stage 04

Resolve

The adjuster works from an indexed file and a cited summary, and makes the call. The record of every agent action sits beside the claim.

Inside the platform

04 / Coverage

Tuned to the line you write.

The same agents, configured for the parties, the correspondence and the documents each line of business actually produces.

Workers' compensation

Injury intake, indemnity and medical correspondence, jurisdictional forms, and persistent outreach to employers and treating providers from first report through ongoing benefit handling.

Property and casualty

High volume first notice of loss, status handling through surge periods, and document structuring across estimates, invoices and inspection reports.

Health

Member and provider communication where every interaction carries the full record, so a question is answered correctly the first time it is asked.

Coverage in detail

05 / Integrations

Built to fit the stack you already run.

Adoption should not ask a claims team to change where they work. MAVALLI reads and writes your systems rather than replacing them.

System of record

Claims management

Reads the claim and writes filings, notes and updates back into it.

Customer records

CRM

Keeps party and policy records consistent with what the agents learn on a call.

Channels

Communication tools

Works inside the email, messaging and telephony your team already uses.

Phone routing

IVR

Sits behind your routing so inbound status reaches an agent instead of a queue.

Analytics

Data warehouse

Feeds structured claim and interaction data to the reporting you already trust.

Connection happens four ways: real-time ingestion, write-back automation, two-way status sync and an open API for the systems you built yourself.

How it connects

06 / Security

Enterprise-grade, by default.

Claims data is regulated data. The agents operate inside the controls you already run, and every action they take is recorded.

Acts inside your permissions

An agent reaches exactly the systems and records it has been granted, through the same access model your team is governed by. There is no shadow copy of your book sitting outside your controls.

Everything is attributable

Every call, message, document read and write-back is logged against the claim, with the agent and the action identified. When someone asks why a claim says what it says, the answer is in the record.

Grounded or silent

The assistant answers from the file and cites what it used. Where the file does not support an answer, it says so rather than producing one. Recommendations are recommendations: the decision and the accountability stay with your adjuster.

Security and compliance

Next step

Tell us where the queue hurts.

Show us the highest volume, most repetitive work on your claims team's plate and we will show you which agents take it off their hands. A short conversation is usually enough to tell.

Get in touch