Case Study

Insurance Claims Automation

A modeled d2b reference architecture: how a DACH property & casualty insurer automates claims intake and first assessment, cutting processing time while holding full BaFin, FINMA and GDPR compliance.

Last updated: August 6, 2026

78%

Faster Processing

€2.4M

Annual Savings

94%

Accuracy Rate

12K+

Claims/Month

The Challenge

The reference insurer processes over 12,000 claims monthly across Germany, Austria, and Switzerland. A legacy system struggles to keep pace with growing volumes and increasingly complex regulatory requirements — the pattern this architecture is designed against.

Manual Document Processing

Claims adjusters spent 60% of their time manually reviewing and extracting data from submitted documents, leading to backlogs and delays.

Inconsistent Decision Making

Different adjusters applied varying criteria, resulting in inconsistent claim outcomes and customer complaints.

Regulatory Compliance

Strict DACH region regulations (GDPR, BaFin, FINMA) required meticulous documentation and audit trails for every decision.

Multilingual Support

Claims arrived in German, French, and Italian, requiring specialized staff for each language region.

The Solution

We built a comprehensive Gen-AI system that automates the entire claims intake and initial assessment process while maintaining full regulatory compliance.

Intelligent Document Processing

Multi-modal AI that extracts and validates data from PDFs, images, and handwritten forms in German, French, and Italian.

Claims Triage Engine

RAG-based system trained on 500K+ historical claims that automatically categorizes, prioritizes, and routes claims to appropriate handlers.

Fraud Detection Module

Pattern recognition AI that flags suspicious claims for manual review, reducing fraudulent payouts by 34%.

Compliance Dashboard

Real-time monitoring and audit trail generation ensuring full compliance with BaFin, FINMA, and GDPR requirements.

intake → redact → assess → route IDLE

1 — A claim arrives

claim-pack.pdf · 3.2 MB · 12,000+ claims a month

Policyholder: K. Brandt
Policy no.: HV-2024-88214
Health note: attached, 4 pages
Type: household · water damage · with photos

2 — What the handler picks up

01Completeness checked against the policypass

02Cover question needing a human1

03Extraction accuracy, measured94%

Assessed, not decided

Representative example from a modelled reference architecture. The design is ours; the specimen document is synthetic and the run is illustrative, not a client deployment.

System Architecture

Implementation Timeline

Phase 1

Discovery & Audit

2 weeks

Deep dive into existing workflows, compliance requirements, and data infrastructure.

Phase 2

Prototype Development

4 weeks

Built working prototype with core document processing and triage capabilities.

Phase 3

Pilot Program

6 weeks

Deployed to single claims team, refined based on real-world feedback.

Phase 4

Full Rollout

8 weeks

Scaled to all DACH operations with comprehensive training and support.

The Results

Average claim processing time reduced from 14 days to 3 days

Claims adjusters now handle 3x more cases with higher accuracy

Customer satisfaction scores increased by 28%

Zero compliance violations in 18 months of operation

ROI achieved within 8 months of full deployment

Technologies Used

PythonAzure Document IntelligenceOpenAIPostgreSQLFastAPI

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