ADDED TO VCA CLAIMSCORE
AI That Works Inside the Claim
ClaimsAI by VCA works inside one claim at a time. It reads the documents on the claim, summarizes what matters and drafts the email or file summary for your adjuster to copy into the claim or set aside. Your adjusters decide.
BUILT FOR EVERY SEAT
- Cargo cover listed on the declarations
- Shipper rejected the load at the dock
- Salvage report: no recoverable value
- Still outstanding: the temperature logNot on the Claim
THE PROBLEM IT SOLVES
A claim arrives as documents: the first notice, the policy, the estimate, the letters. Someone reads every one before anyone can decide, and a claim falling behind its service targets waits for someone to notice.
WHAT CLAIMSAI DOES
Four Capabilities, All Inside the Claim
Documents, Chat, standing checks and first notice. Each one is a job your team does today. ClaimsAI does the reading, the checking and the first draft, then hands the work back to the person who owns the claim.
Ask me what the documents on this claim say.
Documents
Every document on the claim, read and summarized.
- Analyzes the documents on the claim and answers questions about them.
- Summarizes what each document on the claim says, in plain language.
- Works from the documents your team already uploads. Nothing about how they arrive changes.
Reads: the estimates, reports, letters and policy documents on the claim.
Your Team: reads the summary against the document, then decides.
IN THE PLATFORMAsk me about this claim.
Chat
Ask about the claim, and the answer comes from the claim.
- Summarize this claim, or say what is still outstanding on it.
- Check activity against the service timelines, or compare the claim notes to the policy documentation.
- Draft a claim summary or an email response for the adjuster.
Reads: what is on the claim, including its documents, policy documents and service targets.
Your Team: copies what it can use into the claim. ClaimsAI does not update anything in the claim.
Why It Pays: the first draft starts from this claim's facts.
IN THE PLATFORMI keep an eye on what is coming due.
Standing Checks
What needs attention on the claim, raised before anyone asks.
- Whether activity is on pace against the service timelines.
- What is coming due, and what is already overdue.
Reads: the service targets in the client profile, against the claim.
Your Team: decides what it means and what to do about it.
IN THE PLATFORMI help set up the claim at first notice.
First Notice (FNOL)
Help at first notice, so the claim is created properly.
- Helps at claim creation, for teams that need it.
Your Team: decides, as on every claim.
Why It Pays: a claim created properly sets the tone for the whole claim.
IN THE PLATFORM
VCA'S GUIDE
Meet Vicky™. Your team's assistant on the claim, powered by ClaimsAI.
Vicky shows people how VCA works, and she is the face of ClaimsAI.
WHO SHE IS
Vicky is the voice of the product. She walks new users through VCA in webinars and onboarding, with or without ClaimsAI switched on.
WHAT IT ADDS
What ClaimsAI Takes Off the Desk
VCA ClaimsCore is complete on its own. ClaimsAI is added to it to take the reading, the routine checking and the first drafts off your team's desk, so the people who own each claim spend their time on the decisions.
- Reading and First DraftsThe reading and the first draft come off the desk. Your adjusters start from the summary and the draft, not from a blank page or a stack of documents.
- Service Targets and Due DatesWhere service targets are set, they and the due dates are checked on the claim.
- Outstanding and Overdue ItemsWhat is outstanding or overdue is raised on the claim.
| The Work | On VCA ClaimsCore | With ClaimsAI Added |
|---|---|---|
| A Document Arrives | It is on the claim for the adjuster to read. | Ask for a summary of it, and the adjuster checks the summary against the document. |
| Getting Up to Speed on a Claim | The notes, documents and history are all on the claim to read through. | Ask what is outstanding, or for a summary, and the answer comes from the claim. |
| The Email or Claim Summary | The adjuster writes it. | A first draft comes from the claim, for the adjuster to copy into the claim or set aside. |
| Authority and Service Targets | Authority limits set for each user, and service targets where they are set. A reserve above an adjuster's limit goes for approval. | Where service targets are set, they are also checked on the claim before anyone asks, and what is coming due is named. |
| First Notice | The handler works through what arrived with it. | Help at claim creation, so the claim starts properly. |
| Who Decides | The adjuster. | The adjuster, still. |
FOR MGAS, PROGRAM CARRIERS AND MANAGING AGENTS
For the Team That Oversees Claims Someone Else Handles
Where an MGA, a carrier with programs placed or a managing agent places the handling with a delegated administrator, it does not work the claim. It reads what that administrator sends and answers for what it finds. ClaimsAI works for that team the way it works for an adjuster: inside one claim at a time. Across the book, that is VCA Insights →
Documents, Read on the Claim
Where a delegated administrator's claims run on VCA, a report or letter on a claim is read like any other document on it: ClaimsAI summarizes what matters, inside that claim, for whoever is reviewing it.
Reads: the documents on one claim at a time.
Your Team: reads the summary against the document, then decides.
IN THE PLATFORMPartner Performance, per Claim
Where a partner handles your claims in VCA, each claim carries the same standing checks: service clocks running down and items coming due. The flags are on the claim before anyone asks for a report.
Reads: each claim's service targets and what is coming due.
Your Team: sees the flag on the claim and decides what to raise.
IN THE PLATFORMWHERE CLAIMSAI WORKS, AND WHERE IT STOPS
AI where it's practical. Judgment where it belongs.
In claims, a wrong answer does not stay wrong quietly. It becomes a reserve someone relied on, or a coverage note a client quotes back months later.
THE FIVE RUNGS OF A CLAIM DECISION
- ObserveReads and summarizes. Changes nothing.
- SurfaceFlags what is due, overdue or missing.
- DraftPrepares the summary or the email response for a person to copy and use.
- ActThe adjuster sets the reserve, approves, pays.
- Answer for ItThe record shows who decided and what happened.
The first three rungs are ClaimsAI's. The last two stay with your team, as they always have.
FOR YOUR COMPLIANCE REVIEW
What Your Compliance Team Can Check on the Claim
Each ClaimsAI capability works inside a single claim.
- Reserve revised above the adjuster's limitAdjusterSubmitted for approval
- Note written to the claimClaimsCoreApproval requested from Claims supervisor
- Waiting for approvalClaims supervisorShows under Pending Approvals
- Nothing reaches the record unreviewedClaimsAI does not update anything in the claim. What it drafts reaches the claim only when a person copies it there, as their own entry.
Copied by a person, or not on the claim
- Decisions Stay on the RecordClaimsAI never decides or writes to the file. Reserves, approvals and payments are made by your team, and ClaimsCore records who did what and when.
Who decided, on the record
- Inside Your Authority LimitsAuthority limits are set for each user, and limits that change by client or by contract are custom rules VCA builds in an enterprise deployment. A reserve above an adjuster's limit is submitted for approval, routed to the approver you choose and noted on the claim, and the reserve history records who moved it and why.
Your limits, your approvers
Walk Through the Record Controls with VCA →
Four questions are not answered on this page yet: which model sits behind ClaimsAI, whether client data trains any model, how long data is kept, and how ClaimsAI keeps one client's data apart from another's. Ask every vendor on your list, VCA included, for those answers in writing. How VCA Secures the Platform: SOC 1 and SOC 2, Certified →
THE DIFFERENCE
Not another AI adjuster. AI that works for your adjusters.
Some vendors sell AI as the adjuster. Before you buy that, ask who approves each action and where that approval is recorded. ClaimsAI works inside the claim and stops where a decision starts.
See What the Record Shows → The Buying Guide's Questions, AI Included →
THE ONE QUESTION TO ASK ANY VENDOR
Which of these AI capabilities are shipped, and which are roadmap? Ask for the answer in writing, with dates. VCA's own answer: each capability marked In the platform is running inside the claim today.
NEW TECHNOLOGY, SAME APPROACH
We waited on purpose
Every vendor can put “human in charge” on a page. VCA was built from the claim up, by an adjuster, so where AI stops was a claims decision before it was a software one.
When the AI wave arrived, VCA told clients plainly that it was not ready yet. We watched how claims organizations actually used the tools, asked our clients what they wanted, and then decided where AI belongs in the system and where it gives the better outcome.
So ClaimsAI started with documents and first notice: the two places where the work already exists, and where getting it right sets up everything after.
EFFECTIVENESS BEFORE EFFICIENCY
Automation is only good when the result is right. Otherwise you get to the wrong answer faster, and then you do the work twice.
START WHERE THE WORK ALREADY IS
Documents adjusters already upload. The first notice that opens every claim. No new habit required to see the benefit.
THE SEQUENCE
The platform first. ClaimsAI on top of it.
AI reads only as well as the claim it is given. VCA has built the claim record for more than 20 years, so ClaimsAI starts from a record it knows. VCA ClaimsCore is complete on its own, and ClaimsAI is added to it.
The VCA platform has been rebuilt on a modern database and codebase, so the claims depth VCA has built now runs on data clean enough for AI to be useful inside the claim, with a person in charge.
ClaimsAI works from what you have configured in ClaimsCore, such as the service targets in a client profile, which is why the platform comes first and ClaimsAI switches on inside it.
- VCA ClaimsCore is already running where ClaimsAI switches on. It runs at 150+ client organizations across four regions (the US, Canada, the UK, Australia) and the Lloyd's market. Who Runs VCA →
- Discovery first, then live by band. Discovery is a workflow assessment: VCA learns how your claims move, from intake and assignment through day-to-day handling, billing and reporting. Standard License deployments go live in 3 to 4 weeks, Enterprise License deployments in 8 to 16 weeks and Carrier License deployments in 12 weeks to 6 months. The Three Bands →
- Quick to learn. On ClaimsCore, file handlers typically need 30 to 60 minutes of training.
The Platform
VCA ClaimsCore at the center; InsuredConnect, ClientPortal, PolicyConnect, DataBridge, VCA Insights, ClaimsPay and LloydsConnect around it.
ClaimsAI
Documents, Chat, standing checks and first notice, switched on inside ClaimsCore.
IN THE PLATFORM
Questions About ClaimsAI
What is ClaimsAI?
ClaimsAI is VCA's AI capability set, an add-on to VCA ClaimsCore with four capabilities: Documents, Chat, standing checks on the claim, and first notice (FNOL). Each capability works inside a single claim and finds, summarizes and drafts from it. The claims professional decides.
Is ClaimsAI available now?
Yes. ClaimsAI runs inside VCA ClaimsCore as an add-on, and each capability on this page is marked In the platform.
Does AI make decisions on our claims?
No. ClaimsAI finds, summarizes and drafts. Your handlers read, decide and act. Reserves, coverage positions, payments and denials stay human calls, and a reserve above an adjuster's limit goes to the approver you choose.
What happens when ClaimsAI gets something wrong?
It stays on the screen. ClaimsAI does not update anything in the claim: it shows its answer or draft, and a person decides whether to copy any of it into the claim, so the person reading it is the check.
Where does ClaimsAI get its answers?
From what is in front of it. Inside a claim, that is its documents, its policy documents and, where they are set, the client's service targets in VCA ClaimsCore. For an oversight team it is the same: the claim it is reviewing and what is on it.
Is Vicky an AI adjuster?
No. Vicky is VCA's guide. She explains how VCA works in webinars and onboarding, and she is the face of ClaimsAI.
Can we add ClaimsAI to the claims system we already run?
Not on its own. ClaimsAI runs inside VCA ClaimsCore, on the same claim, so it is added to ClaimsCore rather than to another claims system. ClaimsCore is complete without it. ClaimsAI switches on as an add-on, on top of the workflows you have configured.
What can a handler ask ClaimsAI inside a claim?
Questions about that claim, answered from it. For example: check activity against service timelines, compare the claim notes to the policy documentation, identify anything still outstanding, or draft a claim summary or email response for the adjuster to copy into the claim or set aside.
What does ClaimsAI add to VCA ClaimsCore?
Documents analyzes and summarizes the documents on the claim. Chat answers questions about the claim from the claim and drafts the summary or email. Standing checks raise what is behind its service targets or coming due. First notice helps at claim creation. Your adjusters still decide, and VCA ClaimsCore is complete without it.
Bring us a claim where the promise was hard to keep
Bring your hardest questions. We will tell you what ClaimsAI does, what it does not, and what is worth fixing in your claims first.
Request a Demo