Otera + Duck Creek Claims

Overview

Duck Creek Claims stores claim data, manages workflows, and enforces business rules for P&C insurers. The platform tracks each claim through its lifecycle, but adjusters still review details and determine outcomes. When Otera connects to Duck Creek, autonomous AI agents handle that decision layer, enabling end-to-end claims processing without manual intervention bottlenecks.

How It Works

Otera works alongside Duck Creek Claims, extending claims administration into autonomous, end-to-end processing.

• Receive claim data: AI agents receive policy details, loss information, and workflow triggers from Duck Creek, building a complete picture of each claim and its coverage context.
• Assess coverage and liability: Otera's specialized AI agents evaluate coverage applicability and liability exposure on policy terms and reported circumstances, even when the situation involves non-standard scenarios.
• Move claims forward: Agents return decisions to Duck Creek to advance claims through the workflow, setting reserves, approving payments, or triggering next steps as appropriate.
• Raise complex cases: When a claim involves factors that require adjuster judgment, such as disputed liability or unconventional coverage questions, Otera flags it with a summary of the relevant issues for human review.