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How Mutua Madrileña is reinventing claim intake with AI agents
Mutua Madrileña has deployed Rauda's Claim Management AI Agent in a structured pilot to automate end-to-end claim registration, combining automation with real-time policy validation.
End-to-end
claim registration handled automatically by the AI agent
Real-time validation
against each customer's policy coverage
24/7 availability
with no waiting times for customers initiating a claim
Challenge
In claims, the first minutes matter. Customers want immediate help, clear next steps, and zero friction. But traditional claim intake processes are still heavily manual, creating queues, inconsistent data capture, and avoidable back-and-forth while teams confirm policy details and coverage.
Mutua Madrileña, one of Spain’s leading insurance groups, has strong core businesses across motor, home, and health, as well as a large and loyal customer base. The company wanted to reduce time-to-resolution and improve the customer experience without compromising control, compliance, or service quality.
The challenge was clear: bring AI into a critical operational process in a measured, reliable, and evidence-based way.
Solution
Mutua launched a structured pilot with Rauda's Claim Management AI Agent. The agent captures all required information from the customer, opens the claim automatically, and validates coverage by reviewing the customer’s policy in real time.
This is what turns claim intake from a manual first step into an intelligent operational workflow. Data capture alone would still leave teams with the task of checking whether the claim is covered. By validating the policy as part of the intake process, the agent helps reduce unnecessary back-and-forth and supports a more consistent experience from the first interaction.
The initiative is measured against clear operational KPIs, including containment, time-to-resolution, CSAT, and cost per contact. This reflects Mutua’s approach to innovation: structured execution, measurable impact, and continuous iteration until value is proven in production
Impact
The AI agent will enable a faster and more consistent claims intake experience. Customers can initiate a claim at any time, receive immediate guidance, and avoid waiting for business hours.
By combining automation with policy-based validation, Mutua can reduce rework, improve containment, and measure impact through clear KPIs as the team iterates toward scaled rollout.
For insurers, this represents a meaningful shift: a process that has historically depended on human availability can now offer a 24/7 entry point, while maintaining the control, compliance, and service quality required in a high-stakes environment.
