Learn & connect
We learn your SOPs, workflows, systems, and escalation points, then configure and connect Avallon agents.
Platform
AI agents that advance claims end to end
Avallon’s claims-native agents work across documents, communications, workflows, and systems to keep claims moving. From first notice to close, every action remains traceable and your team stays in control.
From first notice to close
At every step, Avallon agents do the reading, chasing, and keying, using your SOPs and the claim’s history. Your adjusters make the decisions: coverage, liability, reserves, settlement, and payment. Every action is logged, and the file stays current in your system.
Someone reports the loss (FNOL) and the claim is opened. The agent takes the report by phone, email, or fax, verifies the policy, and opens the claim in your system before the call ends.
- Real-time claim ingestion
- Write-back automation
- Two-way status sync
The claim is sorted by severity and complexity, then routed to an adjuster. The agent hands your team a complete, cited intake, and any claim your rules flag goes straight to a person.
- Every fact cited to its source
- Your rules by claim type and state
- Flagged claims go to a person
The adjuster confirms the policy, limits, deductibles, and exclusions. The agent surfaces the policy terms and compares them with the facts, so the adjuster decides faster.
- Policy terms cited to the page
- Facts compared with the policy
- Coverage decided by your adjuster
Statements, records, reports, photos, and third-party contacts. The agent calls, emails, and faxes every party on the channel they answer, follows up on your schedule, and reads what comes back.
- Phone, email, fax, and text
- Follow-ups on your schedule
- Cited to the page
The adjuster decides liability, values the loss, and sets reserves. The agent prepares a complete, cited summary and flags exposures, so nothing is missing when the adjuster decides.
- Cited summary in your system
- Exposures flagged
- Your adjusters decide
Negotiation with the claimant, attorney, or provider. The agent reads every demand and letter as it arrives, with each figure cited to its page.
- Demand letters summarized
- Attorney mentions go to a person
- Your adjuster negotiates
One-time or recurring benefit payments, plus releases. The agent issues approved payments through your claim or payment system, sends releases for signature, and answers status calls from the claim file.
- Payments issued in your system
- Releases sent and tracked
- Status calls answered from the file
Subrogation, salvage, and closing the file. The agent contacts the other carrier, tracks the responses, and drafts the recovery paperwork for your approval, with the full history on the claim.
- Recovery outreach and tracking
- Paperwork filed to the claim
- Every action logged
The Platform
We learn your SOPs, workflows, systems, and escalation points, then configure and connect Avallon agents around them. Once connected, they get to work on real claims, follow your processes, and involve your team at the right moments.
Omnichannel Agents
One agent that calls, emails, faxes and texts
Document Intelligence
Reads all claims and cites answers
Memory
Works claims for weeks, remembers every touch.
Learning
Agents kept current with your procedures
Oversight
Scores every call and workflow, and logs every action
Avallon Assistant
Chat, build, and take actions with claims agents
Integrations
Works directly in customer systems
Built on your SOPs
We learn your SOPs, workflows, systems, and escalation points, then configure and connect Avallon agents around them. Once connected, they get to work on real claims, follow your processes, and involve your team at the right moments.
Follows your process
Once connected, they get to work on real claims, follow your processes, and involve your team at the right moments.
Your team is in charge
Your team sets the escalation points, approves every change, and makes the decisions that need judgment.
Expand capacity across the claims organization
Avallon handles routine, high-volume work and complex, PHI-heavy files with the same rigor. Claims move forward around the clock while adjusters focus their time on decisions, exceptions, and the people who need their attention.
- 88%
- Of repetitive workflows handled end‑to‑end
- 31%
- Faster cycle times
- 4.6/5
- CSAT scores with agent interactions
Athens Administrators
“Avallon has made it simple to integrate AI into our claims operations while ensuring our customers’ experience is exceptional.”
Danny Smith, VP of IT at Athens Administrators
Compliance for the realities of claims
Avallon’s security program supports the privacy, healthcare, communications, and data protection requirements that shape claims operations.
Access security documentation, review controls, and submit questions through the Avallon Trust Center.
- SOC 2 Type II
- HIPAA
- GDPR
- CCPA
- TCPA
