AI in Insurance Claims: Continental General’s Roadmap to Faster, Smarter Claims with Nomad’s Doc Chat
If you missed the webinar, watch the on-demand recording here and some brief highlights below.
In our recent webinar, Continental General’s Roadmap to Faster, Smarter Claims with Nomad’s Doc Chat Tambree Borom, Vice President at Continental General, sat down with Nomad Data CEO Brad Schneider to share how her team is using AI to transform long term care claims across the United States. The conversation focused on one core challenge nearly every insurer recognizes immediately: document overload.
The Long-Term Care Claims Bottleneck
For long term care carriers, claim files grow thicker every month a policyholder stays on claim. A single eligibility review can involve:
- Hundreds or thousands of pages of medical records
- Care plans and nurse assessments
- Provider notes and invoices
- Prior eligibility decisions and policy documents
Before Nomad, Continental General’s eligibility specialists were spending hours per claim just to read, index, and pull out the facts required to make a decision. The work was:
- Time intensive, with heavy production expectations
- Mentally exhausting, especially at scale
- Highly specialized, requiring both clinical and technical expertise
As Tambree described it on the webinar:
“[The process] was very time-consuming, very time-intensive...before Nomad.”
Why Continental General Turned to Nomad’s Doc Chat
To keep up with growing claim volumes and rising expectations from policyholders, regulators, and distribution partners, Continental General partnered with Nomad Data to deploy Doc Chat.
Doc Chat can ingest hundreds of thousands of pages per minute across PDFs, scanned documents, and other formats. It then can produce a tailored, eligibility-focused summary, let specialists ask plain-language questions about the claim, and return answers with clickable links back to the exact source page.
For Continental General’s long term care book, the teams jointly designed:
- Custom prompts aligned to the carrier’s own eligibility criteria.
- Structured outputs that map directly to internal workflows and committee reviews.
- A Q&A experience that lets specialists drill into ADLs, dates of service, providers, and benefit triggers.
As Tambree put it, once the requirements are configured, it is “literally like...press a button, go!” The model reads the full claim file, returns a summary, and supports deeper probing when specialists want more detail. As Tambree discusses on the webinar:
“We’re...rolling this out to our new claims team. They are literally selling it to the rest of the examiners. Like, guys, you cannot wait to use this. This is going to be great...this is how you look at the summaries, this is how you prompt it, this is how you ask questions. So, the rest of the eligibility staff, they're excited about using it now.”
Listen to Tambree as she talks about how her team uploads 2,500-page medical records and receives a source-linked summary quickly:
From Four Hour Reviews to Lightning Speed Eligibility Decisions
Before Doc Chat, eligibility reviews at Continental General routinely took 3.5 to 4 hours per claim. That time covered document collection, full-file reading, manual indexing, and preparing a recommendation for committee or final decision.
With Doc Chat in production, Continental General is already seeing a clear path toward significant time and cost savings as the team continues to optimize prompts and workflows. As well as faster movement from documentation to decision, which directly benefits policyholders and families waiting on long term care benefits.
Instead of spending most of the day hunting through PDFs, eligibility specialists now upload complete claim files and receive structured summaries in seconds, use Q&A to confirm key details such as ADLs, care level, and provider history, and prepare committee-ready cases more quickly, while still applying their judgment.
The impact is both operational and human. Fewer hours are spent scrolling and highlighting, and more time is focused on decision making and communication. As Tambree discusses on the webinar:
“The user is...uploading a thousand-page document, and it summarized it in seconds. That was a wow factor for them. Being able to prompt the model with certain questions, and how quickly it's able to return responses to those questions, I'm telling you, it's within seconds...you put in a question, you get a response within about 5 seconds. It's been a wow factor for the users.”
How AI in Claims Raises Quality
Time savings were only part of the story for Continental General. A major theme was trust and how to introduce AI into claims operations without undermining confidence or regulatory comfort. At the outset, some specialists worried AI might miss key nuances in complex files or create regulatory exposure.
Continental General addressed those concerns head on. Tambree emphasized that eligibility specialists remain fully accountable for the final decision. AI acts as an assistant, not an adjudicator.
In practice, quality is going up:
- Cases brought to weekly claim committees are more complete and better structured.
- Summaries highlight issues and inconsistencies that might otherwise be missed.
- Staff engagement is higher because less time is spent on repetitive reading and more on higher value judgment work.
How Continental General De-Risked AI for Claims
Any insurer operating across multiple U.S. jurisdictions must satisfy strict regulatory and compliance expectations before deploying AI on live claims. Continental General took a governance-first, phased approach to the Doc Chat rollout:
- Started with a defined block of non-tax-qualified policies
- Formed a small, cross-functional group led by an experienced team lead
- Used real historical claims with known outcomes to benchmark accuracy
- Iterated with Nomad Data on prompts and outputs based on frontline feedback
By testing Doc Chat on actual cases their team had already worked on, Continental General could directly compare AI-generated answers to their own past decisions. When the model consistently produced accurate, source-linked responses, trust increased quickly among both users and compliance stakeholders.
Looking Beyond Eligibility Claims: Finance, Mailroom, & Fraud Use Cases
One of the most interesting parts of the webinar was the discussion about what comes next. With long term care eligibility running faster, Continental General is exploring additional use cases that many insurers will recognize.
Tambree noted that it is not only claims that can benefit from AI support:
“When I think about our finance area, there are probably some repetitive tasks within that area where they could gain a lot from this type of technology.”
Back office & finance automation
- Identifying repetitive finance workflows that can be partially automated
- Supporting teams with AI driven extraction and validation of key financial data
AI powered mailroom & indexing
- Automatically routing incoming mail and email to the correct claim
- Classifying documents by type, provider, and date
Fraud & red flag detection
- Flagging inconsistencies across providers or time periods
- Surfacing unusual documentation patterns that merit deeper review
For any insurer dealing with multi document claim files and high-volume back-office processes, Doc Chat represents real opportunities to reduce manual effort, improve detection, and deliver a better experience for claimants, partners, and internal stakeholders.
Lessons for Insurers Considering AI for Complex Claims
Continental General’s experience offers a clear, practical playbook for carriers:
- Start with your highest friction process. Medically complex claims, for example, can deliver fast ROI.
- Design around your own workflows. Custom prompts ensure summaries are immediately usable inside existing systems.
- Keep humans in control. Position AI as a reading and structuring assistant. Eligibility specialists still own the decision.
- Validate with real cases. Benchmark AI performance against historical claims to build trust with users and compliance.
- Think beyond summarization. Look for value in intake, indexing, and fraud review where structured insight saves time and reduces risk.
As more carriers adopt AI for claims, expectations around speed, transparency, and auditability will only increase. Insurers who move early will be better positioned to deliver faster decisions, stronger governance, and a superior policyholder experience.
In terms of speed, another key takeaway from the webinar was the ease and speed of implementation. As Tambree Borom shared, Continental General experienced Nomad as a truly plug-and-play solution. Her team was able to start using Doc Chat in production in just a few days, not months. You can hear her describe the implementation experience in this short clip:
Watch the Full Webinar
To dive deeper into Continental General’s journey, watch the full on-demand webinar:
Continental General’s Roadmap to Faster, Smarter Claims with Nomad’s Doc Chat.
You will hear directly from Tambree Borom about:
- The real-world metrics Continental General is seeing from Doc Chat.
- How they structured their rollout across claims.
- Best practices for evaluating AI-powered document tools inside your organization.
Ready to See Doc Chat on Your Own Claims Files?
If you are an insurer looking to modernize document-heavy workflows, we can show you how Doc Chat by Nomad Data performs on your documents.
See how Nomad Data can help your claims teams work faster, with more confidence, and with less manual document drudgery.
