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Anthropic Partner NetworkNVIDIA InceptionTechvantage.ai, Deloitte Technology Fast 50
← All use cases05 / 20
Insurance · United States

Resolution for stalled complex claims

Cases stuck for four months could move again, and leak less money while they do.

Built with a Head of Claims in mindResolution for stalled complex claims — workflow screenshot

The kind of team this fits: a US national P&C claims carrier, a multi state complex and disputed claims desk, roughly 65 handlers, 820 open complex claims at any time.

The morning before

A case that's been open 126 days isn't stuck because it's hard. It's stuck because coordinating five different parties, an adjuster, an attorney, a contractor, a client, and an insurer, falls on one adjuster who's also carrying forty other files that all want the same thing.

Image, the morning before

A photo or illustration of what this looks like today, before any of this runs.

How this could run

Not a feature list. The actual sequence, from the moment the case lands to the moment someone signs it.

  1. 01

    Ownership moves off one desk

    The coordination burden across every party gets taken on directly, not added to an adjuster's queue.

  2. 02

    Every party gets chased in parallel

    Investigation and coordination happen across all parties at once, not one after another.

  3. 03

    The adjuster keeps the final call

    The case gets managed. The decision doesn't get taken away from the person who owns it.

Image, inside Zen Studio

Screenshot of a Zen Studio canvas configured for a workflow like this one.

What doesn't change

The adjuster still makes the final call on every case. What changes is how much of their day goes to coordination instead of judgment.

What this could mean

Illustrative, based on the shape of a workflow like this one. The real number depends on the case, the team, and how it's configured.

90%Cut in complex claim resolution time
40%Lower claims leakage
Image, inside Zen Pilot

Screenshot of the Zen Pilot dashboard or explainability panel for a run of this workflow.

Where this lives in the platform

For a head of claims, a workflow like this starts as a conversation with Zara, describing the process in plain language and getting a first draft of the team back in the same session. Zen Studio is where engineering opens that draft, sets the guardrails node by node, and versions it before it goes live. Zen Pilot is where it actually runs, and where anyone can watch a case move through it in real time, node by node, with the reasoning attached.

Scale this is modelled on

Modelled across 820 open complex claims at any time

See a workflow like this built and running, live.Request a demo
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