Insurance.
Faster claims, efficient underwriting, and fraud detection for insurers—powered by cognitive AI and analytics across your operation.
Manual processes, fraud, and long turnaround times erode profitability and trust. SUMāTO automates and brings intelligence to the entire insurance lifecycle.
12 ways Insurance leverages our portfolio.
Reading the claim report
Takes the policyholder's account and the documentation supplied — photos, reports, estimates, police records — and assembles the file with the data the adjuster needs. Assessment starts from an organised case with the gaps already flagged, not a loose folder to read end to end.
Analysing the applicable policy
Checks what happened against the cover, exclusions, excesses and limits of the specific policy, endorsements included, and flags the points calling for a human decision. It avoids the expensive error of settling under a general condition on a contract carrying negotiated terms.
Detecting suspicious claims
Flags cases that depart from the usual pattern — frequency, amount, overlaps between parties, proximity to inception — and explains what the deviation consists of. Investigators spend their time on the ones that warrant it, instead of reviewing by sampling.
Profitability by line and channel
Allocates premiums, loss ratio, expenses and acquisition cost down to product, channel and intermediary level. It shows which lines carry the result and which are sold below cost — the conversation an aggregate technical result can hide for whole financial years.
Policy issue and renewal
The application is validated, rated against current rules and issued, with documents generated, signed and sent. Renewals prepare themselves and give notice ahead of expiry, so business stops being lost to a reminder nobody got round to sending.
Claims end to end
Each step — assessment, authorisation, repair, payment — moves with its deadline and its owner, and the policyholder is notified at the moments that matter. The team steps in where it has judgment to add, not to push a file that has sat for three days.
Capacity for the catastrophe and the campaign
A catastrophic event multiplies notifications within hours, and a renewal campaign concentrates load into specific days. Capacity expands for that moment and is handed back afterwards, without sizing the whole estate for the worst day of the year.
Protecting policyholder data
Access by role and by file, encryption and a log of every consultation, with the extra care the health data present in many claims requires. If a complaint or an inspection arrives, the evidence of who saw what and when is already gathered.
A desktop for agents, adjusters and brokers
The adjuster opens their desktop from the loss site and the agent from the office, with the same systems and no policyholder data left on the device. Onboarding or removing an intermediary is actioned the same day.
Running the policy and claims systems
Issue, collections and claims watched continuously, with incident handling and maintenance windows agreed in advance. An outage at month-end or mid-campaign is resolved before it reaches the intermediary and the policyholder.
Modernisation and a business roadmap
We order which system is modernised first, what is integrated and in what phases, with the cost and risk of each stage visible. The output is a plan the committee can approve and follow, not a statement of intent.
Which process in the line of business to automate first
We measure volume, cycle time and exception rate across issuance, claims and renewal using your own data. It ends by saying which of the three pays first, what each one demands, and which is better left alone for now.
Assisted underwriting
Assembles the risk file, extracts what determines the rate and checks it against the line's current appetite. The underwriter receives an assembled case with the out-of-guideline items flagged, and spends their judgement on the exception.
Remote loss adjustment by photo and video
The policyholder documents the damage from their phone with step-by-step guidance, and the assessment arrives structured and comparable. The adjuster travels to what genuinely needs presence, not to confirm a dented panel.
Technical and reserving reporting
The technical close depends on matching policy, claim and premium against the same cut-off date. It automates the assembly and classifies differences by cause, so the actuary reviews the number rather than rebuilding it.
How we ensure results in Insurance.
Start with an assessment
Diagnose first and invest after: what is missing, what is urgent, and what it costs.
Build on what you already have
We work on your current systems, without replacing them.
Prioritize by impact
We rank the cases by what they save and by how easy they are to put in place.
Protected data, clear rules
Who can see what, a record of every access, and limits set from the start.
A person has the last word
Technology does the repetitive work; what needs judgment stays with your team.
Measure and improve
Indicators your committee reviews, so you can correct as you go.
The method we deliver with.
Diagnostics, strategy, execution, and resilience, applied to the context of your industry.
Diagnostics (Assessments)
We evaluate readiness, maturity, and risk before we begin — view assessments.
Strategy & Architecture
IT strategic planning and enterprise architecture with TOGAF — learn more.
Project execution
PMI, Scrum, and Design Thinking depending on the challenge — agile projects.
Resilience
Continuity and recovery with DRP and BCP — view continuity.
Experience that spans industries.
We have delivered across very different sectors—banking, government, healthcare, telco, retail, energy—and that cross-cutting experience accelerates every project and reduces its risk.
Mission-critical operations in LATAM
Experience in regulated, highly complex sectors.
The best technology for your case
We integrate our own software and our partners'; we do not tie you to one vendor.
We answer for the outcome
From strategy to 24/7 operations, a single firm is accountable.
AI, data, automation, and security
Capabilities that combine to fit what each industry needs.
What we learn in one sector serves another
What works in banking or telco accelerates healthcare, retail, or government.
Without replacing your systems
It protects your investment and reduces the risk of every project.
What Insurance clients often ask.
How does artificial intelligence improve claims service and management?+
Artificial intelligence lets you handle inquiries continuously, prioritize each claim, and guide policyholders step by step. At SUMāTO, we connect conversational assistants to your systems to speed up first response, reduce resolution times, and free your teams from repetitive tasks. Explore our approach in AI Contact Center and in Analytics.
Can underwriting and policy management be automated?+
Yes. With automation, you can validate data, calculate preliminary risk, issue documentation, and update policies without manual intervention at every step. This reduces errors, shortens issuance cycles, and keeps information consistent across areas. Our team integrates these workflows with your current platforms so they run end to end. Find out how in RPA Automation.
How does analytics help detect fraud?+
Analytics identifies unusual patterns, cross-references information across claims, and flags cases that require human review. This way, you focus investigative effort where it adds the most value and protect the profitability of your portfolio. We design models tailored to your business rules and data sources, with clear explanations for every alert. See our Analytics practice.
How do you support regulatory compliance in the insurance sector?+
We help you structure processes with traceability, automated controls, and auditable records that make it easier to respond to regulators and auditors. We define workflows that document every decision and retain the necessary evidence, so you keep control without slowing down operations. We combine automation with Cybersecurity best practices to protect your policyholders' sensitive information.
What options are there to ensure operational continuity?+
To sustain operations during incidents, we replicate and synchronize your critical data and systems so you can recover service quickly. This protects policyholder service and claims management even in adverse scenarios. We define recovery objectives aligned with your reality and test them periodically. Discover Continuity & DR (DRaaS) for backup and continuity.
How does all of this translate into a better customer experience?+
When service is agile, information is consistent, and processes respond on time, policyholders feel a sense of closeness and trust. At SUMāTO, we bring together automation, data, and contact channels so every interaction is clear and effective. The result is a stronger relationship and teams that devote their time to what truly matters. Start with AI Contact Center.
How we solve for Insurance.
The capabilities with the most traction in this sector, and why.
Automation (RPA)
policy issuance, claims handling and document validation.
Data & Analytics
loss ratios, pricing and fraud detection.
Artificial Intelligence
risk evaluation, fraud detection and assisted policyholder service.
Process Automation Assessment
Issuance and claims are the two processes where the sector wins or loses margin. The assessment evaluates them, rules out those needing redesign first, and estimates the savings.
Insurance, in depth.
- BPM vs. RPA: the difference and when to use each — the mistake of choosing the tool before the problem.
- RPA: automating repetitive back-office work — where it frees real capacity.
- Big data in practice: from Hadoop to Spark — which technology solves which problem.
Let's bring this to your Insurance operation.
Schedule a 90-minute diagnostic, and we'll prioritize the highest-impact use cases for your organization.
Schedule a diagnostic (90 min) →