01
Documents Whole-policy analysis
Review the relevant policy, endorsements, exclusions, and claim evidence as a connected set.
Blueprint use case Enterprise pattern
Insurance claims triage
Compare loss reports with policy language, endorsements, exclusions, and operating rules before routing a claim.
Scoped enterprise engagement · Suggested model mix: QGI Documents, QGI Fusion, QGI Symbolic, and human-in-the-loop agents.
What it is
Claims teams must interpret policy language in the context of the reported loss while identifying exclusions, endorsements, missing evidence, and cases that require specialist review. QGI approaches this as a governed application pattern rather than a standalone point solution.
Designed for Claims and underwriting operations.
Capabilities
Built around the work—not the demo.
02
Controls Deterministic routing
Apply explicit triage rules and escalation thresholds before any downstream action.
03
Review Human review by design
Escalate ambiguity, conflicts, and high-impact cases with the supporting evidence attached.
How it works
One governed path.
- 01
Ingest the claim package
Connect the loss report, policy, endorsements, correspondence, and approved reference material.
- 02
Evaluate coverage signals
Identify potentially applicable clauses, contradictions, gaps, and deterministic routing conditions.
- 03
Send the case to the right queue
Route the evidence package to the authorized adjuster, investigator, or specialist.
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QGI / Blueprint use case
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