Solutions · Insurance & Claims
Put AI employees on the claims desk — governed from day one.
Claims work is regulated, adversarial, and deadline-driven. Pax Equitas staffs the intake desk, the claims desk, and the compliance desk with AI employees powered by engines that run claims operations in production today.
Who this is for
- Public adjusting firms handling policyholder claims at volume
- Policyholder-side law practices building recovery positions
- Claims organizations with field staff and a commission structure
The problems it takes off your desk
Each of these is a claim an engine or role already makes on its own page — arranged here for the industry, never extended.
The first offer gets accepted
Policyholders take what they are given because nobody can tell them, quickly and provably, what the policy actually owes. Settlement analysis turns that into a written, source-cited recovery position.
Carrier estimates miss scope
Catching omissions manually does not scale past a handful of files. Estimate auditing reviews each one against the photographic record and flags what was missed or underpriced.
Every lead still needs a qualifying call
Intake forms collect a name and a phone number. A governed intake flow asks the qualifying questions itself and hands the pipeline structured answers, day or night.
Nobody can prove what was executed when
Agreements get signed across email, paper, and competing e-sign tools. Agreement execution keeps every signature — electronic or scanned — in one auditable record.
Leadership cannot see the pipeline
Operations run on spreadsheets and text messages. A single operating surface makes the pipeline, communications, and payouts visible and accountable.
The team for this industry
Three roles cover the desks a claims organization staffs first: the front desk that never closes, the analyst that drafts a defensible recovery position for a licensed professional to own, and the compliance desk that keeps the evidence trail intact.
How governance plays here
Claims work answers to statutes, deadlines, and opposing counsel. Every AI action here runs under explicitly granted permissions and writes an append-only audit event, so a file can show who — or what — did each step and when. Regulated determinations stay with licensed professionals: the analyst role drafts, and its report is gated behind a human verdict before it can reach a customer.
Security
Claim files are customer records: every row is scoped to your organization and every request is checked server-side, so a cross-tenant read is structurally impossible — an answer a carrier's security questionnaire actually accepts.
Auditability
When a settlement is disputed, the record is the defense. Each privileged action — human or AI — lands in the same append-only log, filterable by actor and organization from the Command Center.
Deployment model
Roll out desk by desk: sandbox for evaluation, staging against your real configuration, production only for verified-Live engines under an approved license — direct, or white-labeled under your firm's brand.
Why enterprises choose this
Positions, not opinions
The claims desk produces written, source-cited work product a licensed professional reviews and owns — defensible in a negotiation, not just faster.
Recovered scope you were leaving behind
Estimate audits surface missed and underpriced line items before an estimate is accepted, at file volumes no manual review keeps up with.
An operation you can actually see
Intake, pipeline, agreements, and payouts on governed surfaces instead of spreadsheets — visible to leadership, attributable per actor.
Proof, with attribution
The claims engines behind this solution were not built for a demo. They run the live claims operations of United Public Adjusters and ACI United — operating companies in the Pax Equitas ecosystem — in production today.
United Public Adjusters & Appraisers, Inc. and ACI United, operating companies in the Pax Equitas ecosystem.
Straight answers
- Does the AI settle claims?
- No. AI roles draft, analyze, and route; regulated determinations are made by licensed professionals. The claims analyst's report is gated behind a human review step before it can reach a customer — that gate is enforced in the engine, not promised in a policy.
- What is actually live versus in development?
- Every role and engine on this page carries a tier chip derived from the product registry at request time. Nothing on this site can advertise a readiness the registry hasn't verified — demote an engine internally and its public chip demotes with it.
- Can this run under our firm's brand?
- The intake, settlement-analysis, agreement, and operating surfaces are available white-labeled — your name, domain, and colors — while maturity labels and the governance layer stay deliberately unbrandable.
Related solutions
See it run on your industry's work.
A demo walks this solution on live platform data — roles, engines, and the audit trail behind them.