BIZAI use case

Policy Endorsement Processing Automation

Insurance — Specialty
Property & Casualty

AEGIS London, a leading UK insurer with over $1B in annual premium volume.

Policy Endorsement Processing
(mid-term policy changes)

Business Challenge

AEGIS London’s underwriters were inundated with tens of thousands of endorsement requests each year—policy amendments arriving in unstructured formats from brokers and agents.

Processing each endorsement manually required interpretation, categorization, and data entry across multiple systems — averaging 5 minutes per endorsement consuming significant underwriting time and slowing service levels.

  • High manual workload

  • Processing delays and bottlenecks

  • Increased potential for manual error and compliance risk

  • Growing operational costs

AEGIS sought a GenAI solution capable of automating the endorsement lifecycle — from understanding policy context to routing and system updates — while operating under strict governance requirements and integrating with its Pega-based platform.

BizAI Solution

Fisent deployed BizAI, its Applied GenAI Process Automation platform, to automate endorsement processing through document understanding, rule-based inference, and contextual categorization.

Implementation details:          

Conducted an accelerator sprint with AEGIS stakeholders to define the automation model.
Configured 55 underwriting rules within BizAI to recognize endorsement details and extract key policy data.
Built a feedback-driven refinement loop enabling rapid improvements to the efficacy of the AI outputs. (we don’t train ANY models)
Integrated BizAI with AEGIS’s existing workflow and Pega systems for seamless data handoff.

The system now:     

Reads and classifies – inbound endorsement documents in any format.

Extracts key data using GenAI-driven contextual understanding.
Explains its rationale for decision-making, improving transparency and auditability.

Apply policy and compliance rules to determine reimbursable vs. non-reimbursable charges, flagging exceptions for audit review and potential fraud detection.

Integration & Workflow

System Integration

Structured outputs flow to AP, claims management, and compliance systems for payment decisioning.

Exception Routing

Non-compliant, duplicate, or unsupported invoices are routed directly to the compliance team with highlighted discrepancies.

Governance

BizAI is able to apply internal audit standards and payer compliance rules, ensuring policy and program adherence.

Auditability

Every extracted field and compliance decision is fully traceable back to the source invoice and governing policy clause.

Standardization Benefit

By digitizing and automating invoice intake and validation, BizAI replaces manual reviews with a standardized, rule-driven adjudication process. This ensures consistent application of reimbursement policies across all caregiver types and service categories — reducing variation, rework, and fraud exposure.

Business Impacts

80–90% reduction in manual invoice review time.

Consistent enforcement of reimbursement policies across all care programs.

Improved compliance visibility through audit-ready documentation.

Faster reimbursement cycles, enhancing caregiver satisfaction.

Reduced fraud and payment leakage through automated detection of invalid or duplicate claims.

Key Takeaway

Fisent BizAI transforms healthcare invoice processing from a manual, error-prone workflow into an automated, transparent and compliant process, ensuring that every charge is validated, reimbursed, and recorded accurately — protecting both the payer and the patient.

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