Kooperativa and MAMA AI: The First Fully Agentic AI System for Life Claims Processing in the Czech Republic

Prague, July 14, 2025 – Kooperativa Insurance, together with MAMA AI, has launched the first fully automated agentic system in the Czech Republic that handles life insurance claims from start to finish – from notification to payment decision.Automation that Speeds Up and Improves Claims Handling
The new AI solution can process standard life claims in an average of just 12 seconds – with accuracy that surpasses manual workflows. If the AI system encounters a case it cannot resolve, it automatically refers the claim to a human adjuster.

Key Benefits:

  • Speed: Decisions in seconds, not days or weeks.
  • Accuracy: Greater consistency than manual claims handling.
  • Transparency: Every decision is traceable and can be reviewed.
  • Control: The system knows when to involve a human.
  • Human focus: Teams are freed up to handle more complex cases.

How Does the Agentic System Work?

This is not an ordinary chatbot or simple automation. It is a next-generation agentic system that:

  • Registers new claims
  • Analyzes medical documentation
  • Identifies the relevant policy terms and evaluation tables
  • Checks exclusions and insured amounts in the contract
  • Proposes and records a decision in the system
  • Prepares all supporting documents for payment
If the AI encounters an unclear or complex situation, it automatically involves a human adjuster.

“This is not a PoC, OCR, or just simple claims. This is an end-to-end process running live!”
— Ondřej Poul, Kooperativa Insurance

Security, Trust, and Adaptability:
Kooperativa insists on full control and trust in the decision-making process. That’s why a custom, internally trained composite AI model was developed, continuously learning from real data and regularly reviewed by specialists. Every AI decision can be checked by a human – transparency and client data security are always top priorities.Why an Agentic Approach?
  • AI understands context: Plans actions based on each case, not just predefined rules.
  • Knows its limits: Automatically escalates cases needing human expertise.
  • Maximum efficiency: Clients receive fast decisions with fewer errors.
Results That Matter
  • Significantly faster claims settlement
  • Greater transparency and trust in the process
  • Reduced administrative burden on staff
Setting a new industry standard:
This project demonstrates how agentic AI can practically and safely transform core areas such as insurance.Want to learn more about MAMA AI agentic solutions?
Contact us via sales@themama.ai or visit https://themama.ai