Claims intelligence for Australian insurers

Know which claim breaches next.

intactly reads the entire claim file, checks what the documents say against each other, and tracks every deadline the claim is under: Code, statutory and scheme. Findings arrive with the source pages attached. In this market, an answer you cannot evidence is worth less than no answer at all.

intactly - claim cockpit Engine live
214 Claim unresolved at four months. Escalate and inform. HOM-2025-08871 · VIC · GI Code Pt 8 268d over
167 Statutory benefits liability decision CTP-NSW-2026-0338 · NSW · MAI Act 2017 11d over
163 Decide application for compensation WC-QLD-2026-0455 · QLD · WCR Act 2003 7d over
157 Commence provisional weekly payments WC-NSW-2026-0912 · NSW · SIRA guidelines 2d left
30 Notify insured of information required MOT-2026-05002 · VIC · GI Code Pt 8 7d left
Integrity finding · capacity
D-0912-04 · p.2
“no lifting above 5 kg, 14 Apr – 12 May 2026”
D-0912-11 · p.4
“observed lifting cartons est. 12–15 kg”
Action: review. Not a decision.

Output from the obligation engine and the integrity examiner. Every row cites the instrument behind it. Every finding carries its source pages.

Built against the instruments you are supervised on
General Insurance Code of Practice ASIC RG 271 APRA CPS 230 APRA CPS 234 Privacy Act - APP 1 AFCA Rules SIRA NSW icare TAC WorkSafe VIC WorkCover QLD ReturnToWork SA FSC Life Code

The problem

Australian claims teams are not judged on how fast they catch a bad claim.

They are judged on delay, on denial, and on whether they can explain a decision eighteen months later to someone who was not there. That is where the complaints land, and it is where the regulator is currently looking.

119,949
Complaints lodged with AFCA in 2025–26
The highest annual volume on record, and the third year running above 100,000.
Source: AFCA annual review
1 in 4
General insurance complaints are motor claim delays
Delay, service quality and claim rejection are the three most complained about issues.
Source: AFCA reporting
10 Dec
Automated decision transparency starts
Privacy policies must describe what decisions are made by automated processes, and roughly how they work.
Privacy Act, APP 1, 2026

Platform

Six engines, one evidence chain.

Four of these match what the global platforms already do well. Two of them do not exist anywhere else, for the simple reason that no other regulator asks for them.

Casefile

Reads the file

Document understanding

Medical, legal, engineering, financial. Scanned, photographed, handwritten. Tuned to the Australian document set rather than a translated American one.

217 document typestarget v1
Signal

Checks it against itself

Integrity examination

Reconciles what each document asserts and surfaces the disagreements: dates, capacity, quantum, coverage, duplication, document provenance.

Minimum 2 source anchorsenforced
Ask

Answers questions about it

Cited claim Q&A

Ask the file anything. Every sentence of every answer carries a document, a page and a quote. Without an anchor the system will not answer.

Zero unsourced claimsenforced
Enrich

Adds what is missing

External context

ABN and ASIC registers, property and title records, Bureau of Meteorology event data, address resolution, ICA catastrophe declarations.

Onshore sourcesap-southeast-2
Clockwork

Watches the clock AU only

Obligation engine

Every timeframe the claim is under, evaluated continuously: the Code, RG 271 dispute resolution, and the statutory clocks of eight jurisdictions.

8 jurisdictions+ catastrophe mode
Ledger

Keeps the receipts AU only

Decision provenance

The record your board, ASIC and AFCA all ask for. Produces the APP 1 automated decision disclosure and the CPS 230 service provider pack without a drafting exercise.

APP 1 · CPS 230 · CPS 234continuous

Approach

Built to survive the review that comes afterwards.

Speed is the easy part. The hard part is being able to show, two years on, exactly what the system saw and why anyone acted on it.

The dispute is never in the structured fields.

Most claims systems only see what somebody typed into a form. The problem is almost always in what nobody typed: the third page of a specialist report, a handwritten note in the margin of a certificate of capacity, a revised scope buried in a builder's email attachment.

Casefile takes the file as it actually exists. Faxes, photographs of paperwork, mixed-orientation PDFs, long correspondence threads. It turns all of it into facts that can be queried and traced back to where they came from.

What that involves
  • Handwriting and annotation captureCertificates of capacity, file notes
  • Poor scan recoveryFax, photo of document, skewed pages
  • Attachment traversalEmail into PDF into embedded image

Comparison

The question is which rulebook it was built against.

The offshore claims platforms are good software. They were written for the FCA, the NAIC and the Canadian codes. What they lack here is not capability.

Capability intactly.ai Offshore claims AI General purpose LLM
Document understanding at claim file scaleThe core engine Yes, Australian corpus Yes, US and Canadian corpus Partial, no layout model
Cross document integrity checkingWhere sources disagree Yes, anchored findings Yes, scored signals No, no persistent file state
Code of Practice clocksAcknowledge, decide, expert reports, four months Native Not modelled No
State scheme statutory clocksSIRA, icare, TAC, WorkSafe, WorkCover, RTWSA 8 jurisdictions Not modelled No
RG 271 dispute resolution30 calendar days, then AFCA Native Not modelled No
Vulnerability and hardship handlingFamily violence, hardship, mental health Native, walled off from integrity No local equivalent No
APP 1 automated decision disclosureRequired from 10 December 2026 Generated Your problem Your problem
Data residencyClaim content stays in Australia ap-southeast-2 Varies, often US inference Varies by provider
CPS 230 service provider packTolerances, dependencies, exit plan Pre-built On request Not applicable
Declines, reductions, recoveriesThe adverse calls People only Automatable Unconstrained

A finding, in full

What actually lands on a claims officer's desk.

This is the real output shape. Note what is here that a scoring product does not produce: both source pages, the named factors, and the innocent explanations.

DOC-0114 · Certificate of Capacityp. 2
…the worker is certified with capacity for suitable duties, no lifting above 5 kg, for the period 14 April 2026 to 12 May 2026, with review by the nominated treating doctor at the conclusion of that period. Return to pre-injury duties is not recommended at this time…
DOC-0139 · Rehabilitation provider reportp. 4
…during the workplace assessment conducted 29 April 2026, the worker was observed lifting stock cartons estimated at 12–15 kg from floor level to bench height without apparent difficulty, and reported having resumed this task "for a couple of weeks now"…
Capacity · possible

Recorded activity falls inside a certified restriction period

Certificate DOC-0114 restricts lifting above 5 kg from 14 April to 12 May 2026. Rehabilitation report DOC-0139, dated 29 April 2026, records lifting estimated at 12–15 kg, inside that period.

Certified restriction No lifting above 5 kg
Recorded activity Lifting 12–15 kg, floor to bench
Date within period 29 April 2026
Innocent explanations Capacity that fluctuates, a graded return to work plan, medical advice to attempt the task, or a loose weight estimate in either document
Next step Clarify with the nominated treating doctor before any adverse action. This finding is not a decision.

Lines of business

Every line runs on a different clock.

Australia does not have one claims regulator. It has a national Code, a corporate regulator, a prudential regulator, an ombudsman, and a separate personal injury scheme in every state.

Value

Run it on your own numbers.

Every input is yours to set and every line of output states where it comes from. No industry averages, no borrowed percentages. Move the sliders. The assumptions are all on screen.

120,000
45 min
$78
900
$1,800
340
$14,000

Commitments

Six things intactly cannot do.

These sit in the data model and the test suite, not in a policy document. A promise that survives a roadmap argument is the only kind worth writing into a contract.

01

It cannot decline a claim

Declines, reductions and recovery actions are recommendations only. There is no setting that changes this, which is usually the first question a board asks.

02

It cannot assert without a source

The system cannot state a fact about a file without a document, page and quote attached. Extractions without an anchor are discarded rather than downgraded.

03

It cannot turn a disclosure against a claimant

Family violence, hardship and mental health signals are walled off from every integrity, liability and recovery path. Crossing that wall raises an error, not a warning.

04

It cannot move your data offshore

Claim content stays in Australian regions, including when a model is being called. No cross border inference, and no exceptions for capacity.

05

It cannot train on your claims

Written into the contract rather than a best effort undertaking. Your file is not our training data.

06

It cannot bill you for a denial

Priced on claims under management. Never on savings share, recoveries or declines. A supplier that earns more when claims are denied cannot be defended at AFCA.

Talk to us

Bring us your slowest cohort.

Six weeks on one portfolio, measured against a matched control on four numbers agreed before we start: days to decision, projected breaches per thousand claims, rework rate at internal dispute resolution, and AFCA referral rate. We publish the method with the result.

We use this to contact you about a briefing and nothing else. No mailing list, no third party sharing. Stored in Australia.

Prefer email? hello@intactly.ai  ·  Open the live demo