AgentAngel.io™ | AxiRate™ Holistic Claim File Review & Audit Suite

Rep / Adjuster Name	Files Audited	Avg QA Score	24h Contact SLA	Monthly QA Status
Sarah Jenkins (#ADJ-8841)	12 Files	96.4%	100% (12/12)	🌟 SUPERIOR
David Ross (#ADJ-8842)	11 Files	94.8%	100% (11/11)	🌟 SUPERIOR
Marcus Vance (#ADJ-4412)	10 Files	78.2%	80% (8/10)	⚠️ COACHING

Compliance Aspect	Total Intakes Analyzed	Pass Rate	Key Performance Telemetry
Call Control & Flow	1,420	100% PASS	Zero unprompted dead-air gaps >6 seconds across all monthly intakes.
2. Empathy & Customer Experience	1,420	99.1% PASS	Immediate safety & injury check executed on 100% of trauma-cue calls.
3. Open-Ended Questions	1,420	98.7% PASS	Uninterrupted loss sequence narrative captured prior to structured details.
Use of Jargon	1,420	100% PASS	Zero unexplained legalese or internal jargon presented to policyholders.
Right Questions for Loss Type	1,420	99.5% PASS	100% impact point, lane change, and airbag deployment questions captured.
6. Set Proper Expectations	1,420	100% PASS	Claim number and 24-hour adjuster callback window delivered on 100% of calls.
Privacy & PII/PPI Safeguards	1,420	100% PASS	Recorded statement consent & caller identity verified before intake.
8. Bot-to-Human Handoff	1,420	99.8% PASS	Context continuity payload passed to human rep with zero caller repetition.
9. Liability Neutrality & Rules	1,420	100% PASS	Strict fault neutrality maintained; zero unauthorized admissions of liability.
Fraud & Red Flags	1,420	100% PASS	Physical evidence contradictions automatically flagged for SIU review.
11. Damage, DRP & Towing	1,420	99.2% PASS	Direct routing to certified DRP repair facilities; zero daily storage fee leakage.

1. Operational & 11 NLP Category Views (13 Set):

2. Scorecards & Performance Reports (5 Set):

🔒 Enterprise PII/PPI Security Safeguard: All document OCR, recorded statement transcripts, and EXIF image extractions execute on zero-retention HIPAA/SOC-2 edge micro-servers. Zero PII/PPI is stored or shared.

EDGE ENCRYPTION ACTIVE

Attached Documents Queue 0 Files Attached

Live ingested file payloads:

📁

Document Queue Empty
Items appear here as you select/drop files into the dropzone buckets or load a demo preset.

Interactive Claim Document Dropzone Select or Drag files into target buckets

🎙️

Recorded Statements

Audio (.mp3, .wav) or Transcripts

📝

File Notes & Claim Screens

System Loss Logs & FNOL Notes

🚗

Damage Photos / Estimate

EXIF Images & Repair Estimates

🚓

Police Report / Other / Invoice

Crash Reports, Towing & Invoices

AxiRate™ Live Audit KPI & Synthesis Demo Results AI AUDIT COMPLETE

Liability Decision Benchmark

3 Days

✅ Completed within 5-day standard

Indemnity Payment Turnaround

4 Days

✅ Paid within 5 days of coverage/liability

🚨 Red Flags & Statement vs. Evidence Analysis

F-VEL · STATEMENT VS POLICE REPORT VELOCITY DISCREPANCY HIGH RISK

Insured Jane Shipman stated speed was ~30 mph in recorded statement. Police Report #DFW-8821 documents 45 ft rear skid marks proving impact velocity exceeded 48 mph in a 35 mph speed zone.

F-COV · COVERAGE & PRIOR REPORT CROSS-LINK MEDIUM RISK

Policy #POL-88192 had an initial report filed at 7:55 AM by spouse John Shipman (Claim #FNOL-3001). Third-party claimant M. Vance report cross-linked to prevent duplicate coverage payout.

F-NEG · ACTIONABLE COMPARATIVE NEGLIGENCE (30% COMP NEG) MEETS >25% CARRIER THRESHOLD

Insured primary fault (70% - excess speed), Claimant secondary comp neg (30% - sudden un-signaled lane change from parking exit into flow of traffic). Exceeds carrier 25% actionable threshold rule.

F-DMG · UNDISCLOSED STATEMENT DAMAGE DISCREPANCY SPECIAL DAMAGES IMPACT

Recorded statement review revealed undisclosed broken prescription eyeglasses ($450.00) and storage release notes omitted from the initial police report.

❓ Additional Investigation Questions to Rule on File

Was claimant's turn signal engaged prior to entering lane? (Request surrounding retail dashcam/CCTV footage).
Obtain official police accident reconstruction notes from Officer #4910 regarding skid coefficient.
Confirm exact timestamp of spouse's prior FNOL call vs 911 dispatch log to rule out post-incident policy changes.

📊 SECTION 2: EXECUTIVE CASE AUDIT & PRINTABLE SUMMARY

VERIFIED CARRIER AUDIT REPORT

AXIRATE™ EXECUTIVE AUDIT SUMMARY REPORT

Master Claim File #FNOL-3001

⚠️ HIGH RISK AUDIT FLAG (88/100)

1. Executive Loss Overview & Document Reconciliation

AI Agent Angel ingested and cross-referenced all attached claim file artifacts (Recorded Statements, Police Incident Report, EXIF Damage Images, and Claim System Logs). The audit identified critical speed discrepancies between the Insured's recorded statement and physical police evidence, as well as a prior report match filed by the policyholder's spouse 20 minutes prior.

2. Operational SLA & KPI Measurements

LIABILITY DECISION

3 Days

Target: < 5 Days (PASSED)

INDEMNITY PAYMENT

4 Days

Target: < 5 Days post-coverage (PASSED)

SUBRO EXPOSURE / COMP NEG

30% Comp Neg

Actionable (>25% Carrier Threshold)

🚨 3. Vehicle Damage, Towing/Storage Release Speed & Undisclosed Statement Damages

Vehicle Damage & Physical Impact Assessment

Insured Vehicle (2023 Honda Accord): Heavy rear bumper deformation, trunk lid intrusion, right rear quarter panel buckle. Estimated repair: $6,450.
Claimant Vehicle (2021 Toyota Camry): Front radiator core support crush, hood crumple, driver headlight shattered. Estimated repair: $5,120.
Structural Safety Alert: Rear frame rail distortion noted on EXIF image inspection. Mandatory teardown authorized.

Towing Release Speed & Storage Mitigation (Measured in Days)

Customer Tow Release Authorization: Executed by policyholder on Day 1 (14 hours post-accident).
Vehicle Relocation Velocity: Vehicle moved from impound lot to DRP repair shop in 1.5 Days post-loss following customer release signature (SLA Target: < 3 Days).
Towing Operator & Charges: Metro Towing & Recovery (#TOW-4491). Initial Tow Fee: $280.00.
Storage Duration & Accrual: Metro Impound Facility (Dallas, TX). Daily Rate: $65.00/day. Total Storage: 1.5 Days ($97.50). Storage capped under SLA limit.

🔍 STATEMENT DISCREPANCY: UNDISCLOSED & UNNOTED DAMAGES ACTIONABLE COMP NEG IMPACT

Cross-referencing the Audio Recorded Statement transcript against the initial Police Report (#DFW-8821) and FNOL Loss Log revealed several critical items omitted from initial police/adjuster notes:

Broken Prescription Eyeglasses ($450.00 replacement): Insured Jane Shipman explicitly noted during recorded statement at timestamp [04:12] that her prescription glasses were dislodged and smashed against the A-pillar upon impact. (Omitted from initial Police Report and initial intake notes).
Aftermarket Dashcam & Equipment Damage ($380.00): Claimant M. Vance reported rear trunk-mounted equipment damage in statement [08:45], unnoted in field appraisal.
Carrier Comp Neg Threshold Alignment (30% Claimant Comp Neg): Per carrier audit rules, Comparative Negligence is flagged as an actionable issue only when likelihood exceeds 25% (Carrier Rulepack Config: 25% – 40% threshold). The 30% Claimant comp neg (sudden un-signaled exit into high-speed lane) qualifies as an actionable issue, allowing personal property and secondary damage offsets during subrogation.

4. Rule Engine Flags & Liability Assessment

F-VEL · VELOCITY & SKID MARK DISCREPANCY

Insured Jane Shipman stated speed was ~30 mph. Police Report #DFW-8821 documents 45 ft rear skid marks confirming impact velocity exceeding 48 mph. Potential speed violation contribution.

F-DUP · PRIOR REPORT MATCH (SPOUSE CROSS-PARTY LINK)

System Alert: Policy #POL-88192 had an initial report filed at 7:55 AM by spouse John Shipman (Claim #FNOL-3001). Third-party caller (M. Vance) linked to neutralize duplicate claim exposure.

F-NEG · ACTIONABLE COMPARATIVE NEGLIGENCE (30% COMP NEG)

Insured primary fault (70% - excess speed), Claimant secondary comp neg (30% - sudden un-signaled lane change). Exceeds carrier 25% actionable threshold requirement.

5. Fault Allocation & ACORD 125 Extraction

DETERMINED LIABILITY

70% Insured / 30% Claimant

Rear-end impact + excess speed vs un-signaled turn (>25% actionable threshold)

ACORD 125 STATUS

96% Intact & Verified

EXIF GPS & Photo Metadata Match

6. Recommended Senior Adjuster Actions & File Rule Questions

Assign dedicated Senior Bodily Injury Adjuster due to high-velocity triage alert.
Request official police accident reconstruction report from Officer #4910.
Issue single Master Claim File #FNOL-3001 for both spouse and third-party claimant M. Vance.
Authorize DRP shop repair estimate + prescription glasses replacement ($450.00) under property damage coverage.

❓ Key Questions to Rule on File:

Was claimant turn signal active prior to entering traffic?
Obtain Officer #4910 skid coefficient notes to finalize comp neg allocation.
Verify prescription eyeglasses replacement invoice against recorded statement timestamp [04:12].

Select QA Report View:

AXIRATE™ DETAILED ADJUSTER QA REVIEW SCORECARD

Adjuster: Sarah Jenkins (ID #ADJ-8841)

Claim File #FNOL-3001 · Audit Date: August 13, 2026 · Reviewer: QA Auditor #104

96% PASS

1. TIMELINESS & SLAs

100 / 100

Contact < 2h · Paid in 4d

2. INVESTIGATION & FAULT

95 / 100

Comp Neg 15% captured

3. EMPATHY & CX

98 / 100

Warm tone · Zero jargon

4. FILE DOCUMENTATION

92 / 100

Notes detailed & logged

🌟 Positive Feedback & Strengths Identified

Exceptional Early Contact: Contacted policyholder within 1 hour and 45 minutes of FNOL filing.
Empathetic Loss Interview: Warm tone and active listening during severe loss description.

98.4 / 100

Monthly Bot Work Completed by Compliance Aspect:

Carrier SOP & Comp Neg Threshold Configuration

3-Tier Coaching Plan Details

🌙 Ollama Overnight Batch Synthesis Queue

Carrier Claims Operational QA & KPI Engine

98.4 / 100