Run a claim by written policy as reports arrive

A claim is worked over weeks, with reports arriving out of order and judgement held in people's heads. Decisimo is claims decisioning software that runs the written policy as evidence reaches the case.

Start free See the claim case

A claim as a case that follows its evidence

Each task runs when the evidence it needs is on the case file. Nothing in the case type states an order. The graph comes from what each task reads, and a changed value runs every task that read it again on its own. Every threshold, flag and outcome shown belongs to a demo case. See case management.

Flow view for Motor claim, repair or total loss, showing tasks linked by evidence dependencies — The Flow view maps the motor claim from First notification of loss to Settlement letter. Claims policy owners can see which evidence each task reads and which tasks run again when it changes.

Repair or total loss decided by rows the team edits

The repair ratio and the engineer's finding determine the settlement basis. Every row writes a reason onto the case. The same ratio can produce a different basis when the engineer's report arrives, so the adjuster review that read the old basis comes back as a new task with current values.

Settlement basis task shows four decision-table rows using repair ratio and engineer’s finding to set the basis and reason — The Settlement basis task shows its conditions and four decision-table rows. Its plain-language reason gives the team that owns claims policy a basis for the review and letter.

Standard risk in one call through a flow underwriters edit

A decision flow answers a standard risk in one call to an endpoint. When a rule changes, the endpoint receives a new release. A case task can run the same rule sets, decision tables and scorecards, including for life risk, so referred risks follow the same policy.

The obligation stays with the insurer

Risk assessment and pricing in life and health insurance is an Annex III high-risk use under the EU AI Act, with obligations from 2 December 2027. GDPR Article 22 applies to an automated decision today, and each decision's input and output can be written to the insurer's own Postgres database. See governance.

Questions we get asked

Can policy run part of a claim and send the rest to a person?

Decision logic runs when its conditions hold, and a human review can go to a role's inbox. The person sees the briefing and form, with the case file one click away.

What happens when a late engineer's report changes an authorised repair?

The changed report updates the case. Tasks that read the changed value run again, and a new adjuster review task is created with current values. The earlier review and its decision stay on the case.

How do fraud indicators fit into a claim?

Fraud indicators are a rule set whose rules write named flags onto the case. The adjuster reads them before deciding what follows. See fraud decisioning.

Can the claims team change a threshold without developers?

Claims teams can edit rule sets, decision tables and scorecards in the portal without code. A function is a mathematical formula built in an editor.

Start with your claims policy

Create a case type from your claims policy and publish it for the team to use.

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