The Challenge
A single claim arrives with a claim form, supporting estimates or medical records, and has to be checked against the policy's own coverage terms and limits before it can move forward. An adjuster reads the claim form, cross-references it against the policy document, and checks the attached estimate for consistency — one claim at a time, entirely by hand.
At real claim volume, the bottleneck isn't deciding coverage — it's the manual cross-referencing required just to get a claim into a state where a coverage decision can be made.
“Reading a claim form is extraction. Checking it against this specific policy's own terms is a consistency judgment — that's the part that needs an agent.”
The Solution
The Saransh Document Intelligence Agent extracts structured fields from claim forms, estimates, and supporting documents regardless of format. A Saarthi orchestration layer then cross-references the claim against the policy's own coverage terms and limits, and checks the attached estimate for internal consistency — flagging genuine discrepancies for adjuster review rather than surfacing every claim as a possible issue.
Reading a claim form is extraction. Deciding whether what it claims is consistent with the policy's own terms and the attached estimate means holding all three documents in context and making a consistency judgment — that's why this needs to be agentic rather than a static document-reading pipeline.
What This Pattern Typically Delivers
Adjusters get a claim record that's already cross-checked against the policy and the attached estimate, instead of doing that reconciliation by hand before a coverage decision can even start.