Our client, a mid-sized insurer, was running claims processing on a 20-year-old mainframe system that nobody wanted to touch — and needed faster claims turnaround without a multi-year core system replacement.
Modernizing a 20-Year-Old Claims System with an Agentic Workflow Layer
Service Provided
Capabilities Utilized
Agentic Architecture, Legacy Integration, Human-in-the-Loop Design
Client challenge
The mainframe was stable but brittle, with no modern API layer and a shrinking pool of engineers who understood it. A full core replacement had been estimated at three years and carried unacceptable business risk, but claims adjusters were spending hours on manual data entry and cross-referencing that a modernized system could largely eliminate.
Our solution
Instead of replacing the mainframe, we built an agentic workflow layer that sits alongside it: a planner-executor architecture that reads incoming claims, gathers supporting documentation, cross-references policy terms, and drafts a recommended action — stopping short of any action a human hasn’t approved. The mainframe itself was untouched; the agent layer integrates through the same screens a human adjuster would use, via a controlled automation interface.
Every agent action that would touch claim status or payout is routed through a human-in-the-loop approval gate, with adjusters able to see the agent’s full reasoning trail before approving.
Results
Average claims processing time dropped from 6.4 days to 2.1 days for the roughly 70% of claims routed through the agentic layer, with the mainframe left completely intact and no disruption to the remaining manual workflow. Adjuster capacity freed up by the automation was redirected to the more complex 30% of claims, cutting the overall claims backlog by 44% within five months.
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