Product
How Daqiq processes a claim.
A complete walkthrough of the claim pipeline — ingestion, tokenization, extraction, policy lookup, agent adjudication, trace emission, and human review. Named mechanisms, named integrations.
The seven steps.
- 01
Ingestion.
Claim evidence arrives as a mix of PDFs, images, and email attachments via a REST endpoint or SFTP drop. Document classification runs first, so Najm liability reports, Taqdeer assessments, and your carrier-authored forms pick up the right schema.
- 02
Tokenization.
Before any outbound inference call, national IDs, phone numbers, IBANs, Najm case numbers, and policy-holder names are replaced with format-preserving opaque tokens. The token-to-plaintext mapping lives in an in-Kingdom KMS-backed vault. Only the final report renderer detokenizes, and only inside the rendering context.
- 03
Extraction.
A frontier-LLM call against a per-document-class JSON schema pulls structured fields out of Arabic text natively — no translation layer. The call runs in europe-west4 because no frontier-LLM provider operates a Middle East region as of April 2026.
- 04
Policy and history lookup.
The agent calls your policy API and claim-history service, both read-only. Missing coverage fails the claim before adjudication, so no decision ever runs against an out-of-scope policy. Every lookup records a trace step with its response hash.
- 05
Agent adjudication.
A tool-using agent — your choice of frontier LLM — runs your claims playbook. Triage, fraud rules, and decision tree live as bilingual natural-language paragraphs that compile to versioned rules. The tool surface is locked down per workflow; nothing else is reachable.
- 06
Decision and trace emission.
The agent writes an append-only trace: every tool call, every retrieval, every rule evaluation, the final decision and its rationale. The trace is SHA-256 hash-chained to the prior trace for the same workflow, so tampering is detectable by construction.
- 07
Human on top of the loop.
Your reviewer sees the decision, the rationale, and the trace in one view. They can approve, override, escalate, or reopen — every human action joins the same trace. Production traffic is gated behind an agreement-rate threshold your team sets.
Integrations.
Named partners, named status. Every integration records the SAMA or NPHIES control it satisfies.
| Integration | Category | Status | Regulation |
|---|---|---|---|
| Najm NAOS | Motor — liability report | shipping | SAMA 15-day adjudication |
| Taqdeer | Property, motor — loss assessment | shipping | Loss adjuster registration |
| NPHIES | Health — claim payload | pilot | CCHI data exchange |
| Absher | Identity verification | pilot | PDPL Art. 6 — lawful basis |
| Elm | Vehicle history | roadmap | Fraud-detection cross-reference |
| ZATCA Fatoora | E-invoicing — phase 1 | shipping | VAT Implementing Regulation, Art. 53 |
| Carrier PAS adapter | Policy system — read-only | shipping | Three Saudi carrier stacks supported |
What your claims playbook looks like.
Your playbook is authored in plain Arabic or English. Your admin edits a paragraph; a versioned rule compiles. Your reviewer sees exactly why a claim went the way it did — the paragraph and the rule are the same object from two angles.
Section 2.3 · Fraud triage If the Najm liability report lists driver_at_fault and the fault party is not the insured, escalate to the senior adjuster queue. Otherwise, route to the auto-approve queue only when the extracted confidence is at or above 0.85.
rule "fraud.triage" {
when:
police_report.driver_at_fault == true
&& fault_party != "insured"
then:
escalate("senior_adjuster")
else:
route("auto_approve", min_confidence: 0.85)
}What you see once live.
Live dashboards, immutable logs, and a cross-border transfer register — every surface inside the product. Reviewers browse the live system.
- Per-claim trace, deep-linkable from any decision. Every tool call, every retrieval, every rule evaluation, the rationale.
- Per-line KPI dashboard: auto-approve rate, escalation rate, denial rate, fraud-hit rate, TAT p50 and p95, average confidence.
- Drift alerts when a workflow's KPIs exceed baseline ± 1.5σ for three consecutive snapshots, with the candidate root cause populated.
- Immutable admin audit log of every staff action: force-save, invoice mark-paid, dispute recorded, password reset issued.
- PII vault access log recording who detokenized what, when, and for which claim.
- Cross-border transfer register with source region, destination region, purpose, byte count, and payload hash.
What runs where.
Every Saudi carrier byte stays in me-central1 (Dammam). The only outbound traffic is the inference call, tokenized in-Kingdom first, routed to europe-west4 because no frontier-LLM provider operates a Middle East region. Moving inference to a KSA-based HSM is a Phase-2 upgrade.
See it on your own claims.
Send us a note with one line of business and where the current process is breaking. We'll scope a diagnostic together.