Orvera AI

Every policyholder conversation finished, documented and audited on the claim file.

Orvera runs the conversation surface for property and casualty, life and annuity carriers. FNOL, claim status, billing and producer service across voice, chat and digital, with every human-handled call audited and written to the file.

SOC 2 Type II, HIPAA Compliant, GDPR
Hear the calls
Why coverage decides it

How does Orvera measure quality across insurance claim conversations?

Orvera AI audits 100% of claim conversations, human-handled and AI-handled alike, scored against state claim-handling rules and the carrier's own claim manual. A closed workflow task tells you a step ran. A transcript tells you what was actually said, so timeliness becomes a record rather than an inference, and compliance receives the exception list instead of a coaching form.

A quality program on a sample

A sampleof conversations reviewed
  • Shows a workflow task closed, not what was said on the call
  • No way to say which conversation missed its clock
  • Coaching evidence, not the record a market conduct exam asks for
  • The AI systems your vendors run stay invisible in the inventory

Orvera

100%of conversations audited
  • Timeliness becomes a record rather than an inference
  • Scored against state claim-handling rules and your own claim manual
  • Human-handled and AI-handled conversations alike
  • A transcript, summary and metadata written to the file every time
What Orvera runs

Which insurance contact center use cases does Orvera handle?

Orvera AI runs the policyholder conversation end to end: First Notice of Loss written to the claim, claim status answered with a specific date, live coverage answers for human reps, digital FNOL with guided photo capture, billing, and the life and annuity desk. All of it on the policy and claims systems you already run.

  1. First notice of lossClaim opened
    1
    Contact

    Loss captured, claim written, number issued

    Structured at intake rather than keyed in afterwards.

    Structured FNOL capturedDone
    Claim number issuedCLM-4471
    Acknowledgment windowWithin 15d
    Injuries, fires and total losses escalated to a person
    01

    First Notice of Loss, taken end to end

    The insured calls from the roadside or a flooded kitchen while the rep keys the loss into the policy and claims systems. Orvera captures the structured FNOL, writes the claim, issues the number and the statutory acknowledgment, and escalates injuries, fires and total losses.

    • Moves claims opened per hour without adding seats
    • The structured loss detail is written to the claim, not to a note
    • Claim numbers issued inside the state acknowledgment window
    • Injuries, fires and total losses escalated to a person
  2. Claim status checkAnswered
    Answer given
    Next step + date
    Source
    Live claim record
    Record read liveClaimCenter
    Next step datedMar 14
    Contact logged to fileYes
    Every contact logged against the 45-day status obligation
    02

    Claim status, answered with a date

    The claimant calls in week three asking where the adjuster is, and the rep reads a file note that has no answer. Orvera reads the live record in ClaimCenter or Duck Creek Claims, gives the specific next step and date, and logs the contact.

    • Moves repeat contacts per claim and claim cycle time
    • Read from the live record, not from a file note
    • A specific next step and a date, stated back to the caller
    • Every contact logged against the 45-day status obligation
  3. Agent Assist, live on the callNo hold
    Surfaced to the rep

    Wind percentage deductible applies on this form edition in this state.

    HO-3 (07 24) · Section I, deductible endorsement

    Average handle time8 to 15% down

    Within the first 90 days, averaged across Orvera customer engagements.

    The approved answer, with the form citation shown
    03

    Live coverage answers while the rep talks

    A rep on a loss call needs to know whether a wind percentage deductible applies in that state on that form edition, and puts the caller on hold to find out. Orvera surfaces the approved answer with the form citation while the call is live.

    • Moves average handle time, down 8 to 15% in the first 90 days
    • The approved answer, with the form citation shown
    • Inside the rep's own flow, with no hold
    • Moves coverage-error rework and reopened claims
  4. Digital FNOL, in your appPhotos accepted
    Session
    Finished in app
    Fell to phone
    No
    Guided photo set6 of 6
    Accepted first passYes
    Claim writtenCLM-4488
    Guides the photo set the estimating process actually needs
    04

    Digital FNOL with guided photo capture

    The insured starts a claim in the app, hits a field only a human can answer, and abandons it into the phone queue. Orvera runs the FNOL as a conversation in the app, guides the photo set the estimating process needs, and writes the claim.

    • Moves claim cycle time through photo sets accepted first pass
    • The FNOL runs as a conversation inside your own app
    • Guides the photo set the estimating process actually needs
    • Moves phone volume originating from abandoned digital sessions
  5. Life and annuity deskSeasonal peak
    Peak staffing
    No seasonal seats
    Forms in good order
    First pass
    Contract owner authenticatedPass
    Values and surrender chargesRead live
    Recommendation givenNever
    Orvera states figures and never makes a recommendation
    05

    Life and annuity values, surrender and RMD

    Contract owners call in December for an RMD figure and in February for a 1099-R, and the center staffs a seasonal peak for it. Orvera authenticates, states the values and surrender charges from the administration system, delivers the forms, and never makes a recommendation.

    • The seasonal peak absorbed without seasonal seats
    • Values and surrender charges read from the administration system
    • Forms delivered in good order on the first pass
    • Orvera states figures and never makes a recommendation
  6. Auto QA, on your human agents100% audited
    100%
    Audited

    Scored against state rules and your own claim manual

    Human-handled and AI-handled conversations alike.

    Conversations reviewedAll
    Acknowledgment complianceRate, not estimate
    Handed to complianceException list
    Every score linked to the transcript that produced it
    06

    Auto QA on every claim conversation

    A QA analyst today scores a 1% to 3% sample per rep on a form built for coaching, not for an exam. Orvera audits 100% of human-handled claim conversations against state claim-handling rules and the carrier's claim manual, and hands compliance the exception list.

    • Moves statutory acknowledgment, reply and status-letter compliance
    • Scored against state rules and your own claim manual
    • Human-handled and AI-handled conversations alike
    • Compliance gets the exception list, not a coaching form
Proof

What do Orvera's insurance calls sound like?

Orvera AI's insurance calls are seven real recorded conversations across property and casualty and life, grouped the way a carrier staffs them. Each one is an FNOL, claim status, billing or producer service contact finished on the policy and claims systems the carrier already runs, and each is transcribed, summarized and audited like every other call on the floor.

Property and casualty

Glenn, first notice of loss

Listen for how the loss detail is captured and where the call moves to a person.

Linda, coverage inquiry

Listen for how the coverage answer is sourced and how the boundary is held.

Grey, claim status check

Listen for how the next step and the timing are stated back to the caller.

Max, travel claim initiation

Listen for how the claim is opened and what documentation is named at intake.

Life insurance

Liam, life claim initiation

Listen for how the notification is taken and where the handoff to a person happens.

Haley, premium payment reminder

Listen for how the amount, the due date and the payment options are handled.

Daniel, enrollment follow-up

Listen for how the outstanding item is named and confirmed before the call ends.

Deployment lifecycle

Orvera AI connects to the policy, billing and claims systems, telephony and ticketing a carrier already runs, and goes live through a structured lifecycle rather than a switch you flip and hope. Your claim manual, coverage rules and scripts become structured workflows, those workflows are tested across real scenarios before a single live call, and live performance sharpens them week over week.

01

Workflow creation

Your claim manual, coverage rules, scripts and past interactions are turned into structured workflows the agent follows.

02

Testing and validation

Workflows are tested across real scenarios for accuracy, escalation handling and compliance before a single live call.

03

Controlled deployment

Agents go live through a defined process, monitored and connected to your policy, billing and claims systems, telephony and ticketing.

04

Continuous improvement

Live performance feeds back into the workflows, sharpening resolution and compliance week over week.

Speed to value

How long does deployment take for an insurance contact center?

Orvera AI reaches full production deployment in an insurance contact center in 3 to 6 weeks, starting from your own claim manual. Coverage rules are mapped into executable logic, tested and validated across scenarios before go-live, and deployed within your existing policy, claims and CCaaS systems. Timelines depend on workflow complexity and enterprise requirements.

3-6weeks

to full production deployment.

  • Your own claim manual and coverage rules mapped into executable logic
  • Tested and validated across scenarios before go-live
  • Deployed within your existing policy, claims and CCaaS systems

Timelines depend on workflow complexity and enterprise requirements.

Enterprise-ready

Orvera AI scores 100% of claim conversations against state claim-handling rules and the carrier's own claim manual, and writes a full transcript, structured summary and metadata to the claim or policy file every time. State unfair claims settlement practices regulations put a timer on the conversation itself, and a multi-state carrier runs fifty of those clocks at once.

Approved-knowledge grounding

Agents answer only from the forms and manuals you approve, no open-web guessing.

An answer for the AI inventory

Governance sits above the models, with the controls on it evidenced.

Written to the file

A full transcript, structured summary and metadata on every interaction.

Granular controls

Permissions, guardrails and policy, configured per channel and use case.

SOC 2 Type II
SOC 2 Type II
HIPAA Compliant
HIPAA Compliant
GDPR Compliant
GDPR Compliant
Orvera AI
Get started

How does an insurance carrier get started with Orvera?

Orvera AI starts on the calls a carrier already has. Orvera AI builds, deploys and runs the operation on the policy, billing and claims systems already in place, with full enterprise deployment in 3 to 6 weeks.

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