Case studies

Outcomes, architecture and ROI — not just pilots

Programmes delivered for health insurance and banking, documented at the level a risk committee will accept.

Flagship

Explainable Claims Decision Copilot

Challenge

  • Manual claims review across large document packs
  • Inconsistent decisions between reviewers
  • No defensible rationale trail for audits

Solution

  • GenAI + RAG over policy wordings and clinical guidelines
  • Agentic workflow for validation, deduction and query drafting
  • Vector database with version-aware retrieval

Results

  • ~60% reduction in review effort per claim
  • Turnaround time cut from days to hours
  • 100% of recommendations traced to cited clauses
Architecture

Reference pipeline

  1. 01Claim intake
  2. 02Document OCR
  3. 03Chunk + embed
  4. 04Vector retrieval
  5. 05Policy reasoning agent
  6. 06Explainability layer
  7. 07Audit log

Screenshot — reviewer view

Side-by-side claim pack and recommendation, with clause highlights and confidence.

Screenshot — audit view

Full prompt, retrieval and decision log exportable per claim.

ROI estimate

For 100k claims/year at 18 minutes average review: ~18,000 hours saved annually.

Banking

Multi-agent fraud investigation platform

CrewAI-based agent crew for triage, evidence gathering and investigator handoff.

Challenge

  • Alert overload
  • Manual evidence collation
  • Low true-positive rate

Solution

  • Specialised agent roles
  • Automated evidence packs
  • Explainable risk drivers

Results

  • Faster triage cycle
  • Higher investigator throughput
  • Consistent case documentation
Programme

AI Transformation Accelerator outcomes

Health insurer

  • 3 use cases prioritised in 3 weeks
  • MVP live in day 62
  • Rollout roadmap approved

TPA

  • Straight-through rate lifted
  • Query letters auto-drafted
  • QC sampling automated

Bank

  • Document intelligence MVP
  • Model governance pack delivered
  • Scale plan for 4 regions

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