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Agent · Backlog

Claim Severity & Reserve Adequacy Agent

Predicts claim severity, duration and litigation propensity at intake and as the file develops, recommends case-reserve adjustments and flags claims for early expert intervention.

Not yet specifiedAssistiveComplexity: High
This agent is in the backlog. Registered interest decides which agents are specified and prototyped next.

What it does

  • Score severity and expected total incurred from claim features
  • Detect reserve inadequacy versus prediction and recommend changes for adjuster approval
  • Flag litigation propensity and attorney-involvement risk
  • Stratify the open inventory for supervisor review
  • Feed actuarial reserving with leading indicators

Systems and data it works with

  • Gradient AI claims
  • Kumo severity models
  • ClaimCenter/Duck Creek reserving
  • Actuarial systems
  • Data warehouse