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Industry pack · Insurance

Catch the recovery you paid away. Sign the demand before the deadline.

Agents re-read closed and open claims for missed subrogation, overpayment and deadline risk, draft demands where every sentence cites the file, and a named specialist signs. Shown for Harborline Mutual, a fictional carrier.

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Harborline Mutual (fictional carrier) · fictional names, simulated data

Demand composer with citations and signature gate (simulated data) Simulated data
  1. ClosedPaid $18,450 as single-vehicle
  2. FlaggedMissed subrogation, 94%
  3. HeldL2+ specialist required, P-05
  4. SignedDemand logged, $18,450 in pursuit

The problem

Leakage happens after the claim looks finished.

A claim is paid and closed. A police report arrives nine days later naming another driver at fault, and nobody re-reads the file. The recovery right is still there, but the clock on it is running.

  1. 01

    Late documents, no re-read

    Police reports, invoices and estimates that arrive after payment rarely trigger a second look.

  2. 02

    Deadlines everywhere

    Acknowledge, decide and pay clocks vary by state and line; internal recovery windows sit on top. The rules shown in the demo are illustrative.

  3. 03

    Fairness must be provable

    Automation that denies claims is a risk. Every adverse decision has to be a human one, and auditable.

How it works

Four agents and a supervisor. A person on every decision.

The healthcare pattern on the ThoughtShieldAI platform: catch early, draft with evidence, a named human signs, clocks escalate, the ledger counts. Nexus governance and Pulse cost tracking are visible throughout.

  1. Leakage Sentinel

    Re-scores open and closed claims when new documents arrive, across six leakage types.

  2. Subrogation Drafter

    Drafts the demand; every sentence cites a page in the claim file.

  3. Supervisor

    Holds drafts by value and type for the right human level under Nexus policy.

  4. Specialist signs

    Sign stays locked until every citation is opened. Coverage decisions are always human.

    Human step

  5. Deadline Escalator

    Acknowledge, decide and pay clocks, with drafted letters for an adjuster to approve.

  6. Recovery ledger

    Leakage prevented, recovered and in pursuit, with value per $1 of model spend.

The human approval

Priya Raman · Senior Subrogation Specialist (fictional)

Opens all seven citations, then signs the demand. The demo makes zero automated denials by design.

The scenario

Claim HM-AU-118407: paid, closed, and reopened.

A fictional personal auto claim at Harborline Mutual. People and carriers are fictional; deadline rules are illustrative.

  1. 01

    A closed claim comes back

    The Leakage Sentinel re-scores a claim paid at $18,450 and closed, after a police report arrives nine days later. Missed subrogation, 94% confidence.

    Leakage inbox with deadline clocks (simulated data) Simulated data

  2. 02

    The evidence in the file

    The police report cites the other driver for running a red light, and a witness confirms it. The timeline shows nobody re-read the file after payment.

    Claim view with timeline, documents and agent findings (simulated data) Simulated data

  3. 03

    Drafted, held, reviewed, signed

    The Subrogation Drafter writes 8 sentences with 7 citations. The Supervisor holds it for an L2+ specialist with 21 days left on the internal deadline. Priya Raman opens all 7 and signs.

    Demand composer with citations and signature gate (simulated data) Simulated data

  4. 04

    Other clocks, escalated

    Acknowledgement and status letters are drafted ahead of illustrative deadlines for an adjuster to approve and send.

    Deadline escalations with drafted letters (simulated data) Simulated data

  5. 05

    Ledger and audit

    "In pursuit" rises by $18,450. The audit log shows every step, and the model cost for the claim is $0.47.

    Recovery ledger with fairness and audit panel (simulated data) Simulated data

Governance and lineage

From source data to outcome, every link kept.

The decision chain behind this scenario, as ThoughtShieldAI records it. Each step can be opened in the live demo.

  1. Source data

    FNOL, payment record, police report (received 9 days after payment), witness statement

  2. AI recommendation

    Leakage Sentinel: missed subrogation at 94%; Subrogation Drafter: 8 sentences, 7 citations

  3. Agent collaboration

    Supervisor holds for L2+ specialist under policy P-05; 21 days to internal deadline

  4. Human approval

    Priya Raman, Senior Subrogation Specialist, opens 7 of 7 citations and signs

  5. Execution outcome

    Demand logged to the other carrier; $18,450 in pursuit; $0.47 model cost

Atlas

Agent roster

What each agent can and cannot do, its model route and its cost per claim.

Nexus

Seven policies

Value and type thresholds for human review; no automated denials; coverage decisions only by people.

Pulse

Cost per claim

Model spend by agent and value recovered per $1 of spend.

Security

Fairness and audit

Human override rate, flag-rate parity by region and an append-only audit log.

Live demo

Play it yourself.

The full Insurance Claims Integrity app runs right here, offline, with simulated data. Press Play demo for the guided scenario (about 76 seconds), or click around freely. Reset is in the top bar.

/demos/insurance/overview Simulated data Open in new tab (opens in a new tab)
Open the live demo

Designed for screens 1280 px and wider. On a phone it opens full screen.

Outcomes

What the scenario changed.

$18,450
moved into pursuit from a closed claim
7 / 7
citations opened before signature
$0.47
model cost for the claim
0
automated denials, by design

SimulatedSimulated outcomes for a fictional carrier. Not a customer result.

Questions buyers ask first

Does the system deny claims?

No. Coverage decisions, denials and reservations of rights are only made by people. The demo records zero automated denials by design.

Which leakage types are covered?

The demo covers six types, including missed subrogation, overpayment, vendor invoice disputes and salvage, plus deadline escalations.

Are the deadlines real statutes?

No statutes are cited. Clock rules in the demo are illustrative and vary by state in practice.

Is Harborline Mutual a real carrier?

No. Harborline Mutual, the people and the claims are fictional, and the data is simulated.

See it on your own workflow.

A 30-minute walkthrough of the live demo, then a conversation about the agents, data and approvals in your environment.

Book a demo Open the live demo

Opens an email to hello@anvevoice.app

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