Success stories
Tecniseguros

Conversational AI for claims processing in the insurance sector

Conversational AI for claims processing in the insurance sector

Tecniseguros, one of Ecuador's leading insurance brokers, worked with Crata AI to build an AI assistant that guides customers through claims processing, validates documentation and routes complex cases to an agent with full context. The system cut processing time by 90% and lets customers resolve their questions on the spot.

A claims process that relied on manual work

Tecniseguros is one of Ecuador's largest insurance brokers, with more than 50 years in the industry and 250 professionals. Its push to bring insurance closer to the customer shows in its digital channels, where a growing number of people manage their policies.

Every validation depended on manual checks that stretched the timeline, and meanwhile the customer had little visibility into where their case stood. Between the manual validations and that lack of visibility, every open claim was a customer waiting for news.

In a sector where peace of mind is exactly what you sell, timing matters. As claim volumes grew, repetitive queries took up time the team would rather have spent on the cases that truly needed expert judgment.

An AI chatbot that guides customers through every claim

With Crata AI, Tecniseguros implemented an AI chatbot that guides the customer through the whole claim, checks documentation as it comes in and, when the case calls for it, hands it to an agent with all the context already gathered.

The assistant handles questions and repetitive tasks on the spot, and brings in a person only for complex cases. That way the customer moves forward without waiting and the team focuses where its judgment truly adds value.

The assistant covers the full claim cycle:

  • Guides the opening of the claim step by step.
  • Automatically validates the documents the customer submits.
  • Adapts its answers to the type of claim.
  • Lets the customer check the status of the case at any time.
  • Transfers the case to an agent with full context when needed.
Turn every query into an instant answer

Repetitive queries overload your team and keep customers waiting. At Crata AI we build AI chatbots that resolve instantly and bring in a person only when it's truly needed.

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90%
Less processing time
per claim, compared with the previous manual process
5x
Faster for the customer
when resolving their questions about the claim
50%
More claims handled on mobile
compared with the channel before the chatbot launched

The technology behind the claims chatbot

The chatbot combines several layers of artificial intelligence that work together to understand the customer, validate their documentation and connect with the broker's systems.

  • Conversational AI: leads the conversation with the customer and guides them through the claim.
  • Language models (LLM): interpret queries and generate answers adapted to each type of claim.
  • Natural language processing: understands what the customer writes in their own words.
  • Document validation: automatically checks that the documentation submitted is complete and correct.
  • API integration: connects the chatbot to the management systems to check the status of the case in real time.

If your team is exploring conversational AI for customer service and claims handling, Crata AI can help you design it.

Book a free diagnostic session to talk through your case: Talk to our experts

Contact us at info@crata-ai.com

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