Otera + EIS Suite

Overview

EIS provides cloud-native core insurance through its OneSuite platform, including PolicyCore for policy administration and ClaimSmart for AI-powered claims management. The platform manages policies, billing, and claims, but underwriting decisions, claims adjudication, and exception handling still require manual intervention. Otera's AI agents take over the decision layer, autonomously evaluating situations and advancing operations to completion.

How It Works

Otera works alongside EIS Suite, extending modern insurance operations into autonomous processing.

• Access transaction data: Agents retrieve policy details, claim records, and customer interactions from EIS OneSuite's customer-centered architecture, establishing context for autonomous processing.
• Evaluate underwriting: Otera enforces business rules, returning decisions and quotes without manual underwriting queues.
• Process claims: AI agents assess claims, determining coverage applicability, and triggering settlement, database updates and payments automatically.
• Route complex cases: When claims involve coverage disputes or submissions require specialized review, Otera routes them with full analysis and recommendations for high-velocity approval.