BFSI
Every claim, assessed right and
closed end to end, on AgentOS.
AI agents verify coverage against the right policy clause, catch the fraud and inconsistencies a manual pass misses, and run the claim from first notice to payout, bringing in an adjuster only where judgment is genuinely needed.
TRUSTED BY 1000+ ENTERPRISES
A clean claim and a disputed one
wait in the same queue.
Most claims operations run every file through the same manual steps, and only find out if a decision was accurate after it’s already been paid out. Nothing about that gets faster, or more consistent, just because the claim was straightforward.
Evidence gets assembled by hand
Photos, reports, estimates, and policy documents arrive through different channels and get pieced together manually before anyone can even confirm coverage applies.
Cycle time keeps stretching
The average property claim still takes 40.7 days from first notice of loss to final payment, and most of that time is spent waiting on someone, not deciding something.
Assessment quality depends on who’s on shift
Two adjusters can review the same evidence and land on different payouts, and there’s no consistent check on either call until an audit finds the gap, often months later.
Fraud hides in the claims nobody flags
An estimated 10% or more of property and casualty claims carry some element of fraud, and most of it isn’t caught at intake. It surfaces later, if it surfaces at all.
AgentOS gets the claim right.
Then, it gets the claim done.
Every claim checked against the right policy clause. Every payout checked against the assessed loss. AgentOS runs the whole file from first notice to payout, bringing in your team only for the fraud flags and the disputes.
Vitos
AI agents run the case, stage by stage
Reminders · Outreach · Negotiation
Command
Human judgment, built into the flow
Oversee · Approve · Override
Calibrate
Every call held to policy
Audit · Fair Practice · Coaching
Pulse
Learns from every case, closes the loop
Trends · Signals · Recommendations
First notice to final payout,
one continuous flow.
Five stages. One system running underneath all of them.
Your team steps in exactly where a claim genuinely needs a person, and nowhere else.
LAYER KEY |
V Vitos – agents at work
C Command – human in the loop
C Calibrate – audit & compliance
P Pulse – learns & recommends
First Notice of Loss & Intake
FNOL Agent
Captures the loss over chat, voice, or app, instantly.
No human needed
Every FNOL runs start to finish on its own.
Intake logging
Every contact scored against SLA and IRDAI standards.
Channel & timing
Tracks first-notice channel mix and time-to-open, by claim type.
Coverage Verification & Triage
Coverage Agent
Checks the policy & cover, flags exclusions, routes by complexity.
Ambiguous exclusions
Coverage specialist steps in only when the wording is unclear.
Coverage audit trail
Every determination logged with the exact clause it used.
Dispute clustering
Flags where coverage disputes cluster, by policy type & exclusion.
Investigation & Assessment
Assessment Agent
Collects evidence, checks consistency, screens for fraud.
Flagged & high-value files
Adjuster reviews inconsistent files, investigator takes flagged cases.
100% fraud coverage
Every fraud screen logged and auditable, not just some.
Fraud patterns
Surfaces fraud signals across claims, not just within one file.
Decision & Adjudication
Decision Agent
Applies policy terms, drafts the approve, partial, or deny call.
Denials & disputes
Adjuster makes the final call on denials and disputed claims.
Fairness standard
Every decision held to the same standard, either way.
Denial trends
Every decision held to the same standard, either way.
Settlement, Payout & Closure
Settlement Agent
Calculates, verifies subrogation, pays, closes claim.
Large settlements
Claims manager signs off before payout on big or negotiated cases.
Full audit trail
First notice to final payment, ready for regulator review.
Cycle time & leakage
Tracks cycle time and leakage, and where claims stall longest.
Claims stop waiting by default.
Straightforward files settle on their own. Your adjusters spend their time on the fraud flags, the disputes, and the calls that actually need judgment, and every one of those makes the next screen sharper.
Where AI and human intelligence work as one.
Every layer in that architecture runs on two things working in concert: AI agents and human intelligence.
One workforce. Built into the system.
Agents handle what can be handled. They execute, resolve, and complete work across every system, at any scale, without waiting. Humans own the moments that demand judgment: approving, intervening, deciding. The system knows the difference and routes accordingly.
They share the same context. The same workflows. The same operational layer. Nothing is siloed, nothing is duplicated, and nothing falls through.
The system doesn’t just settle the claim.
It gets sharper at catching the one that shouldn’t.
Vitos and Command settle the claim. Calibrate and Pulse learn from it. Every FNOL, every assessment, and every payout sharpens how fast the next clean claim closes, and how early the next fraud signal gets caught
“Our teams finally spend time on what matters most. Kapture AgentOS handles the execution, so nothing slips through.”
VP-Customer Experience
If it’s part of your claims process, we can build the agent for it.
No two insurers settle claims the same way. We sit with your team to map your coverage rules, investigation triggers, and sign-off thresholds, then build and configure the agents to match exactly, not the other way around.
We didn’t start with AI.
We started with the work.
We’ve spent years inside real operations, across industries, seeing the exceptions, the edge cases, and the moments that actually need a human. AgentOS is built from all of that, not guessed at.
We’ve already seen the exceptions
Millions of real interactions, real failures, real edge cases. That experience is built into the system, not added on after.
Full-stack, AI-native
Designed together as one system, not bolted together from separate tools.
Your stack. Your rules
Full flexibility to run on your infrastructure, your models, your data, with zero lock-in.
Secure by design.
Built for BFSI compliance.
Claims processing touches some of the most sensitive information a customer shares: medical records, financial loss details, and identity documents. We follow enterprise-grade compliance standards and best-in-class encryption to keep it protected, and audit-ready.
AES-256 encryption
Role-based access
IRDAI & DPDP compliant
Frequently Asked Questions
AgentOS automates FNOL intake, coverage verification, evidence collection and cross-checking, fraud screening, settlement calculation, and payout end to end. A human steps in only for coverage disputes, fraud flags, high-value claims, and denials.
No. AgentOS handles the volume that doesn’t need judgment, so your team’s time goes to the calls that do, including disputed liability, confirmed fraud, and claims where the payout genuinely needs a person’s sign-off.
You set the rules. Each stage has defined trigger points, such as an ambiguous exclusion during coverage verification or a fraud flag during assessment. The claim is automatically routed to the right specialist with full context attached.
Yes. Every claim, whether settled instantly or reviewed by an adjuster, is logged and scored against your fairness and turnaround standards as it happens, so it’s ready for regulator review without reconstructing the file after the fact.
Yes. AgentOS connects to your policy administration system, claims management platform, payment rails, and CRM. You bring your existing infrastructure; we don’t ask you to replace it.
You can bring your own model, use Kapture’s models, or run a mix. The same flexibility applies to your voice stack and data, with no enterprise-grade lock-in.
It doesn’t have to. We work with your team to map your actual coverage rules, investigation triggers, and sign-off thresholds, and build the agents around your process rather than forcing you into a standard template.
Assessment and settlement agents flag distress signals in real time during the interaction itself and route the case to a claims adjuster with the flag and reasoning attached, instead of surfacing days later.
Yes. A claims manager can join any live interaction mid-call, with full context handed over instantly for disputes or claimants who need additional support.
Pilot deployments typically launch within weeks, scaling from a single claim type or region to full volume with a controlled ramp-up.
More of the BFSI journey, on the same system.
Account and card servicing doesn’t run in isolation. Here’s what else AgentOS handles across the account lifecycle.
Loan Origination
Application to disbursal, run end to end, with the same system picking up the account the moment a payment is missed.
Lending
Collections
Reminders, negotiation, and recovery, run as one continuous flow from pre-due to pre-legal, with human effort only where risk demands it.
Lending
Account & Card Servicing
Balance queries, card blocks, limit changes, and servicing requests, resolved end to end without a ticket queue.
Servicing
enterprise with Kapture.
Claims processing doesn’t have to take 40 days anymore.
Settle straightforward claims instantly, catch the fraud and disputes that need a person, and give your team full context the moment a claim needs judgment.
- First notice to final payout, run on one OS
- AI agents that act, adjusters that judge, a loop that keeps getting sharper
- Deployed across 1,000+ enterprises in 60+ countries
TRUSTED BY THE TOP ENTERPRISE COMPANIES
+1833-386-0222 (USA)
enquiries@kapture.cx
