How unidentified-user4321/claimwise works
This product assists insurance customers and claim employees through claim submission, automated assessment, and human disposition. The documented assessment stages combine fraud scoring, description classification, deterministic policy checks, retrieved policy evidence, and similar-claim detection; reviewers then record actions and investigation history. The React client talks to FastAPI, whose services coordinate assessment and persistence. The README documents several capabilities whose internal wiring was not sampled, so those links are shown only where the documented workflow supports them. External provider and database links reflect the described integrations.
Main entry points: analysis.py Assessment orchestration · App.tsx Role-based app · database.py PostgreSQL · api.ts API client
Components 27
User experience
- Role-based app
frontend/src/App.tsx - Client claims
frontend/src/pages/SubmitClaim.tsx - Employee review
frontend/src/pages/EmployeeClaimDetails.tsx - Investigation history
frontend/src/pages/InvestigationHistory.tsx - Session mapping
frontend/src/services/session.tsx - API client
frontend/src/services/api.ts
API and identity
- FastAPI app
backend/app/main.py - Auth routes
backend/app/api/auth.py - Claim routes
backend/app/api/claims.py - Analysis routes
backend/app/api/analysis.py
Claim assessment
- Assessment orchestration
backend/app/services/analysis.py - Fraud prediction
backend/app/ml.py - Description classification
backend/app/ml.py - Similar claims
backend/app/services/claim_similarity.py
Policy intelligence
- Deterministic checks
backend/app/policy_checks.py - Policy analysis
backend/app/rag/policy_rag.py - Policy retrieval
backend/app/rag/retriever.py - Pinecone vectors
backend/app/rag/pinecone_store.py
Claim records
- Review actions
backend/app/services/claim_review.py - Status transitions
backend/app/services/claim_status.py - Claim context
backend/app/services/claim_context.py - PostgreSQL
backend/app/db/database.py - Domain records
backend/app/db/models.py
Other components
- Client
- Claims employee
- Clerk
- Gemini
Connections 33
- Client → Role-based app: uses
- Claims employee → Role-based app: uses
- Role-based app → Client claims: routes clients
- Role-based app → Employee review: routes employees
- Role-based app → Investigation history: routes history
- Role-based app → Session mapping: checks session
- Session mapping → Clerk: authenticates with
- Session mapping → API client: resolves identity
- Client claims → API client: submits claims
- Employee review → API client: records decisions
- Investigation history → API client: requests history
- API client → FastAPI app: sends requests
- FastAPI app → Auth routes: dispatches auth
- FastAPI app → Claim routes: dispatches claims
- FastAPI app → Analysis routes: dispatches analysis
- Auth routes → PostgreSQL: reads and writes
- Claim routes → PostgreSQL: reads and writes
- Analysis routes → Assessment orchestration: invokes assessment
- Assessment orchestration → Claim context: builds claim context
- Assessment orchestration → Fraud prediction: scores fraud risk
- Assessment orchestration → Description classification: classifies description
- Assessment orchestration → Deterministic checks: checks policy rules
- Assessment orchestration → Policy analysis: analyzes policy
- Assessment orchestration → Similar claims: finds similar claims
- Assessment orchestration → PostgreSQL: persists analysis
- Policy analysis → Policy retrieval: requests evidence
- Policy retrieval → Pinecone vectors: searches vectors
- Policy analysis → Gemini: generates analysis
- Claim routes → Review actions: records review action
- Review actions → Status transitions: validates transition
- Review actions → PostgreSQL: writes review history
- Claim routes → PostgreSQL: reads investigation history
- PostgreSQL → Domain records: maps records