Insurance · Operations

Samso Industry Demo · Updated May 2026

Operations for Insurance

P&C ops is the headline function - claims FNOL document intake, policy renewal triage, medical-bill + loss-run review, and the SIU + audit motion across 14.8K LTM claims. Samso runs the back-office workflows that lets a $310M specialty carrier hit a 24-day claim cycle, 96.4% extraction accuracy, and 97.4% combined ratio with leaner ops.

Function KPIs · how the operations org reads its own week

Hours reclaimed / week

184

+84 LTMAcross FNOL · renewal · med-bill · audit

Doc extraction accuracy

96.4%

+3.2pp LTMACORD · police reports · medical · loss runs

FNOL → first contact

4.2 hr

vs 4.0 hr target12-wk trailing across queues

Claim cycle (avg)

24 d

vs 18 d targetFNOL document intake bottleneck on auto BI

Weekly hours reclaimed by managed workflow - last 12 weeks with cumulative overlay

WEEKLY · HRS / WK · STACKED BY WORKFLOW · CUMULATIVE HOURS OVERLAY · MOCK DATA

04692138184HRS / WK1.8K960100CUM HRSW1W2W3W4W5W6W7W8W9W10W11W12

Claims + policy workflows

Claims FNOL + photo + police-report intakePolicy renewal triage + bind-packet QCMedical-bill + loss-run + vendor-invoice review

Audit & investigation

Audit + SIU document review (fraud + recovery)

Twelve services · sized to insurance

Each tile is what Samso runs in this function for a insurance org.

01 · Service

Document Extraction Pipelines

ACORD forms, police reports, medical bills, loss runs, and bind packets parsed into structured fields - straight into the policy admin and claims systems.

Docs / mo

4.6K

Accuracy

96.4%

Hours / wk

84

02 · Service

Project Management Tool Creation

State filings, product builds, and renewal-rollout workflows built on the existing PM stack - UW, actuarial, and IT all see status and risk.

Workflows live

12

Cycle time

−28%

03 · Service

Email Triage & Classification

Producer inbox, claims inbox, and underwriter desk triaged into categories (FNOL, endorsement, certificate, audit) - routed with SLA timers.

Emails / wk

3.2K

Auto-classified

92%

04 · Service

SOP Generation from Recordings

Claims SOPs, FNOL scripts, and underwriting playbooks drafted from adjuster-call recordings and supervisor walk-throughs - DOI + market-conduct aligned.

SOPs / qtr

32

Update cadence

Quarterly

05 · Service

Cross-System Data Reconciliation

Daily recs across policy admin ↔ claims ↔ billing ↔ GL ↔ reinsurance - break flags inside 15 minutes, variance caught before close.

Recs managed

28

Break detection

15 min

Hours / wk

24

06 · Service

Internal Knowledge Base / RAG

RAG over underwriting guides, claims manuals, state DOI bulletins, and reinsurance treaties - adjusters and UWs get sourced answers instead of paging managers.

Documents

14K

Queries / wk

680

Citation rate

100%

07 · Service

Workflow Orchestration Builds

FNOL → assignment, renewal triage, endorsement processing, and SIU referral flows orchestrated across systems - DOI-ready audit logs and clean hand-off.

Flows live

10

Steps managed

184

08 · Service

Contract Review & Extraction

Reinsurance treaties, vendor MSAs, and producer agreements parsed for cession terms, commission grids, and key dates - flagged into UW and finance.

Contracts / mo

140

Clauses tracked

640

09 · Service

Reporting Pipelines

Combined ratio, loss + LAE, claim cycle, persistency, and Schedule P reports auto-generated from policy + claims systems - same set UW and CFO use.

Reports / mo

26

Auto-coverage

92%

10 · Service

Calendar & Scheduling Agents

Producer visits, agency audits, claim IMEs, and EUO depositions scheduled across the footprint - conflict-aware reschedules with adjuster availability.

Meetings / wk

380

Reschedule rate

13%

11 · Service

Audit & QA Automation

Internal QA over claim files, UW files, and producer compliance - sample selection, exception flags, and remediation tracker for market-conduct readiness.

Files reviewed / mo

1.4K

Exception rate

3.2%

12 · Service

File Organization & Tagging

Policy files, claim files, producer agreements, and DOI correspondence tagged for retention, revision, and audit ask - record-retention enforced by state.

Files tagged

180K

Retention compliance

100%

What you get · every week & every month

Concrete deliverables, not just dashboards.

Deliverable

Weekly hours-reclaimed report

Every Monday: hours reclaimed by workflow (FNOL, renewal, med-bill, audit) with backlog status, claim-cycle delta, and SLA breaches flagged for ops leadership.

Deliverable

Daily reconciliation summary

Daily break list across policy admin, claims, billing, and GL - every break aged, owned, and routed to the right LOB or corporate team.

Deliverable

Quarterly market-conduct + audit pack

DOI market-conduct binder kept current - claim handling, UW files, producer compliance, complaint logs - refreshed every 90 days for state regulators.

Deliverable

Always-on internal RAG

Underwriting guides, claims manuals, DOI bulletins, and reinsurance treaties searchable with citations - adjusters get sourced answers, not Slack threads.

Insurance · Operations

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