Otera + Guidewire ClaimCenter

Overview

Guidewire ClaimCenter stores claim data, manages workflows, and enforces business rules for insurers worldwide. The platform tracks each claim through its lifecycle, but adjusters still review details, assess coverage, and determine next steps. When Otera connects to ClaimCenter, autonomous AI agents collaborate to take over that decision layer, enabling end-to-end claims processing from first notice through resolution.

How It Works

Otera works alongside ClaimCenter, extending claims administration into autonomous, end-to-end resolution.

• Receive claim data: Agents pull policy details, loss descriptions, and workflow triggers from ClaimCenter, assembling the full context needed to evaluate each claim.
• Assess coverage: Otera's specialized AI agents enforce policy language against the reported loss to decide coverage applicability, even when the situation doesn't match a standard scenario or involves ambiguous circumstances.
• Advance claims: Agents progress claims through the workflow by returning coverage decisions, liability assessments, and next-step instructions to ClaimCenter, reducing cycle time.
• Escalate with context: When a claim requires adjuster expertise due to complexity or severity, Otera raises it with a full summary of findings so the adjuster can engage immediately.