Agentic AI for claims management
Capco and Yarowa built an AI-powered claims workflow, cutting manual interactions by 90%, speeding provider vetting, and delivering production-ready solutions in weeks.
The client challenge
Our client is a Government Sponsored Entity (GSE) that was facing increasing complexity around streamlining regulatory mapping. Manual regulation-to-control mapping processes were slow, inconsistent and resource-intensive, limiting transparency.
How Capco can help
The client needed a solution that could accelerate regulatory control alignment and enhance confidence on the outcomes. Capco partnered with the client and implemented an AI-powered solution using an iterative approach to automate the regulatory mapping process.
The approach involved:
- Breaking down regulatory text into discrete compliance obligations
- Mapping regulations to internal controls, identifying overlaps and coverage gaps
- Recommending new controls where regulatory obligations were not fully met
- Evaluating model performance through multiple prompt variations and human-crafted benchmarks to validate accuracy, semantic relevance, and consistency.
Outcomes achieved
The client was able to scale regulatory mapping capabilities without compromising quality or compliance. The approach was extended to other processes for a broader GenAI adoption.
The benefits include:
- 71% of users reported significant time savings on mapping tasks
- Delivery of reliable, repeatable mapping outcomes across prompt variations
- Demonstrated the solution’s deep understanding of regulatory requirements.
AI Infused success stories
