Insurtech Federato launched Federato Claims, an end-to-end claims management system built on the same AI-native platform as its underwriting, policy administration and billing products.
The system captures coverage decisions, reserve movement and claim reasoning as structured data. It then sends those signals back into underwriting, pricing and product while the claim remains open.
Federato built this feedback loop on its federated context graph, the same architecture behind the rest of its policy lifecycle software.
That shared architecture keeps claims linked to underwriting, policy and billing data. It also carries context through each interaction and handoff, so policyholders don’t have to repeat the same information as a file moves through the process. Federato says embedded AI automation gives carriers a faster claims operation and a smoother customer experience.
William Steenbergen, co-founder and chief technology officer at Federato, said claims is where insurers find out whether their underwriting worked. As AI agents speed up underwriting decisions, he said insurers need a structured loop between claims and underwriting.
Legacy systems often treat claim discovery as the end of a file. Federato built Claims to turn that discovery into the next underwriting, reserving, appetite or policy-form decision.
William Steenbergen, co-founder and chief technology officer at Federato
Claims account for up to 80% of an insurer’s costs, and few functions carry more influence over loss ratio and margin.
Carriers still lack enough visibility into claim decisions, even though claims often reveal the next loss trend first. Rising severity, unpredictable catastrophe activity, litigation pressure and social inflation keep pushing loss costs outside prior models. The result isn’t theoretical. It hits reserves, pricing and portfolio steering.
Legacy claims systems record decisions, but they don’t connect claims to the risk, policy and underwriting context behind the loss. They also don’t give insurers real-time insight into decision quality or portfolio direction.
Bolt-on AI helps with summaries, correspondence and suggested next steps inside the claim file. It speeds up individual tasks, but it doesn’t capture the reasoning behind coverage decisions or identify patterns forming across open claims.
Claims leaders then lose time. They don’t see inconsistent decisions before those decisions become paid loss. Underwriters don’t get early signals to adjust risk selection, pricing or product strategy. The system gets faster, but it doesn’t get smarter.
Federato Claims closes that loop by linking activity inside each claim to decisions shaping the book. Coverage activity, reserve movement and claim reasoning enter the system in real time. The platform shows where decisions drift, where a clause triggers repeated disputes, or where reserve changes and overrides cluster across a portfolio.
With that context, leaders act before emerging patterns turn into loss ratio problems. The business learns from each claim instead of closing files and moving on.
If a clause keeps causing disputes, product teams rewrite the form in the same system before more policies go out with the same language. That reduces future disputes and litigation risk before it starts.
If a segment looked healthy at bind but starts showing early severity pressure, underwriting tightens appetite or adds new business conditions before the pressure reaches the loss ratio.
When reserves keep running above estimate, pricing teams adjust the rate for that segment at renewal instead of absorbing the surprise later.
Federato Claims also manages the full claim process, from first notice of loss through payment, inside one system. An AI agent guides FNOL intake, captures structured facts and identifies missing information before the claim reaches an adjuster. As new facts arrive, Federato checks them against applicable policy language and surfaces missing details, ambiguity or concerns for adjuster review.
The system keeps an audit trail without forcing teams across multiple stitched-together tools. It records the rationale and policy language behind every coverage decision.
Brokers and policyholders check claim stage and outstanding items through their own portal instead of calling the adjuster for updates. That reduces rework, missed issues and inconsistent decisions across claims teams.
The financial impact lands in the P&L. More consistent coverage decisions reduce leakage and improve combined ratio. As claims insight flows back into underwriting and rate setting, margin has a cleaner path to improve over time.
