Otera + OneShield

Overview

OneShield provides cloud-native policy administration, billing, and claims solutions to P&C insurers and MGAs, supporting lines of business across personal, commercial, and specialty insurance. The platform automates the policy lifecycle and claims intake, but underwriting decisions, claims processing and adjudication, and exception handling still require manual intervention. Otera's AI agents take over the decision layer, autonomously evaluating situations and completing operations end-to-end.

How It Works

Otera works alongside OneShield, extending insurance operations into autonomous processing.

• Access insurance data: Agents retrieve policy records, claim files, and workflow states from OneShield's cloud-native platform, establishing context for autonomous processing.
• Evaluate submissions: Otera deterministically executes underwriting guidelines and rating rules to new business and renewals, returning decisions without manual review delays.
• Process claims: AI agents decisively assess claims at incident level against coverage and policy terms, determining liability, system updates, and payments autonomously.
• Route exceptions: When claims involve complex coverage questions or submissions require specialized underwriting, Otera routes them with full analysis and recommendations.