Who we fit
Actigy for insurance operations & claims teams
Direct answer
Actigy is a strong fit for carriers, MGAs, and TPAs that need claims intake, FNOL, and pre-adjudication capacity that holds SLAs through volume spikes. We run intake validation, evidence bundling, document indexing, and pre-adjudication routing with QA and audit-ready records, while your licensed adjusters keep every approve/deny decision.
What you’re accountable for
What insurance operations & claims teams deal with
- Irregular FNOL documentation is breaking your intake SLAs
- Claims leakage and rework are eroding loss ratios
- CAT events and seasonality spike volume unpredictably
- You need examinable, state-audit-ready records
- You must keep adjudication authority with licensed adjusters
Is Actigy the right fit?
When Actigy is a strong fit
- Intake, indexing, or pre-adjudication exceeds in-house capacity
- You want faster cycle time and lower leakage with QA
- You need audit-ready records for state examinations
- You want adjusters to keep every claims decision
When Actigy may not be the fit
- You expect Actigy to approve or deny claims
- You want a core claims platform rather than an operations team
Proof
In an anonymized P&C TPA engagement, Actigy cut claims intake TAT from 42.5 minutes to 4.2 minutes and leakage to 0.3% of volume, at 100% NAIC compliance.
FAQ
Questions from insurance operations & claims teams
Does Actigy adjudicate insurance claims?
No. Actigy runs intake, FNOL validation, evidence bundling, indexing, and pre-adjudication routing with QA; your licensed adjusters keep every approve, deny, and payout decision.
Can Actigy handle CAT-event volume spikes?
Yes. Capacity flexes for catastrophe events and seasonal spikes, so intake and indexing keep their SLAs without permanent over-hiring.
Are records audit-ready for state examinations?
Yes. Every action is documented with maker-checker QA, so claim files stand up to state audits and examinations.
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See if Actigy fits your team
Tell us the process you want to outsource. Actigy will assess scope, complexity, staffing, and delivery cost, then propose a pilot.