Reinventing Claims: How Agentic AI and Orchestration Streamline Insurance Workflows

Insurance has always been about balancing risk with trust. Behind every claim, though, is a complicated web of processes that can slow everything down. That is changing. Agentic AI is stepping in to simplify and accelerate claims automation, freeing up time for insurers and enhancing the customer experience.

However, to truly harness the potential of Agentic AI, organi`ations must go beyond simply embedding models into tools - they need orchestration. Agentic Orchestration enables AI agents to operate within structured workflows that are transparent, auditable, and compliant with regulations. 

With platforms like Camunda, insurers can unify BPMN-modelled processes with dynamic AI-driven decision-making, ensuring every step, whether automated or human, is accountable and observable.

Smarter Auto-Adjudication

Auto-adjudication (the automatic evaluation and settlement of claims) is not a new idea. What is new is the level of sophistication Agentic AI brings to the table. Instead of relying on rigid, rule-based systems, agentic AI can assess claims with a deeper understanding of context, precedent, and policy specifics.

For example, when a straightforward auto insurance claim is submitted, like a cracked windshield, an agentic AI system can evaluate the damage report, cross-check the coverage details, verify the repair costs against a database, and approve the payout within minutes. 

No human adjuster needs to intervene unless something unusual pops up.

When embedded within Camunda’s orchestration layer, these agents operate within BPMN-defined steps, enhancing automation without sacrificing compliance or transparency. This integration also supports traceability and can request human input where confidence is low, preserving both speed and accountability.

The result is faster resolutions, fewer errors, and happier customers. For insurers already applying this kind of AI-powered efficiency, the payoff includes shorter cycle times and lower handling costs.

Smarter Claims Triage

Claims triage has always relied on human judgment. Adjusters weigh the urgency, complexity, and risk of each case before assigning it. Agentic AI changes that recognize patterns in data (claims history, incident details, and even external risk signals) and automatically sort cases by priority.

AI can instantly identify high-risk cases that need human review and fast-track low-risk ones. That means less time waiting, fewer handoffs, and more consistent outcomes. It also improves fraud detection by recognizing outliers and triggering deeper analysis when something doesn’t look right.

Camunda’s agentic orchestration approach allows developers to configure these logic pathways visually and programmatically. 

This ability to act on real-time insight is becoming standard in financial services more broadly, where companies use AI to make decisions faster and operate more smoothly. The same principles apply here. Prioritizing claims quickly and accurately not only reduces costs but also makes insurers more agile and responsive in high-volume or crisis scenarios.

Better Customer Communication

Many frustrations in insurance stem from poor communication. People want updates, clarity, and timely answers. Agentic AI can now manage most of those conversations directly, whether through voice, text, or live chat. It can guide policyholders through the claim submission process, provide real-time status updates, and offer clear next steps.

Done well, it doesn't feel like talking to a robot. It feels like getting help right when you need it. And unlike traditional scripted chatbots, agentic AI understands nuance. It can tailor responses to the situation, pick up on frustration or urgency, and escalate when necessary.

This is part of a broader shift across industries, where AI is reshaping how trust and service are delivered, without sacrificing clarity or empathy.

And the impact on operations is real. According to Gartner, by 2029, agentic AI will autonomously resolve 80% of common customer service issues without human intervention. That will drive a 30% reduction in operational costs, while freeing up human teams to focus on more sensitive and nuanced interactions.

Within Camunda’s orchestration framework, customer interaction agents can be embedded directly into larger workflows. This ensures seamless transitions between AI-driven updates, human oversight, and downstream system triggers, enabling continuity and consistency at every point of interaction.

Why This Matters Now

Insurance companies face growing competition, tighter margins, and rising customer expectations. Every part of the business is under pressure to do more with less. 

Those who embrace agentic AI argue that automation is not only reducing overhead but also enhancing productivity. They are providing their teams with better tools and their customers with a better experience.

Some are already seeing results by reimagining core insurance processes, showing that the shift is both achievable and valuable. But results depend on execution.

That’s where orchestration platforms like Camunda stand out, providing the bridge between AI autonomy and enterprise governance. By unifying structured and agentic tasks within a single process model, insurers gain flexibility without compromising control.

At BP3, we help insurers enhance their operations using AI, with solutions built around speed, clarity, and long-term value. Whether you are looking to reinvent claims, improve customer response times, or make better triage logic, our consulting and AI services are designed to get you there faster.

If you’re ready to rethink your insurance workflows, talk to us. At BP3, we make AI practical, actionable, and aligned with your goals.