Agentic Reasoning: One Clear Plan for Every Claim
What is Agentic Reasoning?
Agentic Reasoning is AI that doesn’t just summarize—it equips claims teams with the context to make confident decisions. That guidance then turns claim goals into sequenced actions: planning, acting, and learning while staying grounded in facts, rules, and outcomes.
At CLARA, our agentic reasoning is built for claims. It empowers adjusters with decisive guidance by answering five essential questions on every file:
- What’s the next best action?
- When should we intervene?
- Why is risk or complexity rising?
- How have similar claims resolved?
- How could this specific claim play out?
Not Just AI—AI That Knows Claims
We don’t stop at summaries. CLARA’s agentic reasoning combines:
- Predictive models that flag cost, severity, and litigation risk
- Fact-grounded retrieval (RAG) that ties every recommendation to your data
- Causal and counterfactual reasoning that anticipate outcomes
You get guidance that’s intelligent, explainable, and tailored to your book of business.
Three Tools, One Clear Direction
Claim Event Indicators
Risk Notes
Claims Guidance
The Power of Agentic Orchestration
Within our platform, multiple specialist “agents” (medical insight, legal, negotiation, SIU) collaborate behind the scenes so adjusters receive one coordinated next-best plan, complete with timing and rationale.
The result? Fewer hand-offs, tighter cycle times, and more consistent outcomes on complex claims.
How It Works
Agentic orchestration runs as a closed loop that continuously turns signals into action. As new evidence arrives on a file, specialized agents contribute instrumental perspectives. Once actions are taken, outcomes flow back into the loop—updating the briefing, re-prioritizing what matters now, and sharpening the next recommendation.
How It Works
Agentic orchestration runs as a closed loop that continuously turns signals into action. As new evidence arrives on a file, specialized agents contribute instrumental perspectives. Once actions are taken, outcomes flow back into the loop—updating the briefing, re-prioritizing what matters now, and sharpening the next recommendation.
How It Works
Agentic orchestration runs as a closed loop that continuously turns signals into action. As new evidence arrives on a file, specialized agents contribute instrumental perspectives. Once actions are taken, outcomes flow back into the loop—updating the briefing, re-prioritizing what matters now, and sharpening the next recommendation.
How It Works
Agentic orchestration runs as a closed loop that continuously turns signals into action. As new evidence arrives on a file, specialized agents contribute instrumental perspectives. Once actions are taken, outcomes flow back into the loop—updating the briefing, re-prioritizing what matters now, and sharpening the next recommendation.
How It Works
Agentic orchestration runs as a closed loop that continuously turns signals into action. As new evidence arrives on a file, specialized agents contribute instrumental perspectives. Once actions are taken, outcomes flow back into the loop—updating the briefing, re-prioritizing what matters now, and sharpening the next recommendation.
Detect & brief
Claim Event Indicators raise moments that can change the outcome; Risk Notes summarize risk, complexity, and context.
Propose
Specialist agents generate candid actions (e.g., schedule utilization review, recommended reserves review, initiate outreach).
Prioritize
The orchestrator scores options against policy, impact, and timing; resolves conflicts; sequences a plan.
Deliver
Adjuster sees one plan with rationale, required artifacts, and suggested scripts/ranges.
Adapt
As new data arrives, the plan updates; completed steps and outcomes feed back into future decisions.
The AI Playbook for Claims Professionals
Learn how augmented intelligence is revolutionizing casualty claims.
Clarity That Every Role Can Act On
Agentic reasoning turns scattered signals into a single, explainable plan—so every role spends less time searching and more time moving files forward.
Adjusters
Supervisors & Leaders
SIU & Litigation
Ops & Execs
IT & Data
Operational Impact
- Less swivel work and rework; more first-attempt right actions
- Earlier interventions on rising-risk files
- Reduced variance across adjusters and regions
- Clearer documentation for QA and audits
FAQs
| How is this different from GenAI summaries? Unlike GenAI summaries, Agentic Reasoning delivers explainable recommendations and orchestrated plans grounded in your data, rules, and precedent. |
| Where do recommendations and ranges come from? From a reasoning stack that blends predictive models, fact-grounded retrieval, and causal analysis. |
| How do CEIs and Risk Notes connect? CEIs provide the timing signal (the when), while Risk Notes provide the context (the why). Together, they drive the next-best action. |
| What’s the implementation timeline? We align on objectives, data sources, and workflows; roll out in phases; and measure adoption and outcomes from day one. |
| How is data privacy handled? All recommendations stay within your governance controls, with auditable inputs, explainability, and policy guardrails applied by design. |