The claim is in the inbox. The policy is in another system.
A single claim arrives as a declaration form, photos, an expert report, invoices and an email chain, while the policy wording and the coverage data sit in the policy administration system. GUIDSE unifies the two, masks personal and health-related fields, and lets AI agents assemble and check the file. The handler decides, with every source one click away.
Where the work gets stuck
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Files built by hand
Handlers spend their time collecting documents instead of assessing them.
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Coverage checked from memory
Exclusions, deductibles and endorsements are checked against the wording only when someone has time.
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Signals spread across files
Repeated parties, invoices or repairers are hard to spot when every claim is read separately.
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Supervisory scrutiny
Decisions supported by AI must be explainable and traceable.
Processes GUIDSE runs
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Claims file assembly
Classifies incoming claim documents (declaration forms, expert reports, repair quotes, medical certificates) and builds a complete file in the claims system.
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Coverage pre-check
Compares the facts of the claim with the policy wording, endorsements and deductibles and gives the handler a cited summary.
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Repairer and expert invoice audit
Checks invoices against approved quotes and tariff agreements and routes only the deviations.
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Policy wording review
Monitors wordings and broker agreements for clause changes and inconsistencies across versions.
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Cross-file signal detection
Flags recurring parties, bank accounts or invoice patterns across claims for review by the fraud team.
The same six steps in every sector.
The difference is in the U: your data is unified and masked before any agent acts on it.
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Gather
Connect the policy administration and claims systems, the claims mailbox and the expert portal.
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Unify
One file per claim, with lineage. Names, national numbers, health information and bank details are masked at the Privacy Wall.
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Interpret
Agents read the documents against the wording.
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Decide
The handler accepts, rejects or asks for more information. Agents never settle a claim.
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Systematize
Every new document triggers the file check. Cross-file scans run weekly.
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Evolve
New products and wordings are added without rebuilding the flow.
Data and privacy
Claims files contain health and personal data that GDPR protects strictly, and insurers are subject to DORA's ICT-risk rules. AI used for risk assessment and pricing in life and health insurance is classed as high-risk under the EU AI Act. GUIDSE masks sensitive fields before any AI provider sees them, keeps a tamper-evident record of every agent action, and leaves the final decision with a person.