Cognitive agent assistant

A system comprising:

• a claims preprocessor, the claims preprocessor comprising:
• an identifier to process claim data to identify one or more claims that are to be adjudicated from amongst a plurality of claims;
• a robotic process automator, in communication with the claims preprocessor, the robotic process automator to orchestrate adjudication of the identified one or more claims based on the claim data;
• a rules engine, in communication with the robotic process automator, the rules engine to adjudicate the identified one or more claims based on pre-defined rules;
• and
• a fall out handler, in communication with the rules engine, the fall out handler to:
• determine if any of the identified one or more claims are incorrectly adjudicated;
• and
• identify an issue associated with incorrect claims adjudication on determining that any of the identified one or more claims are incorrectly adjudicated;
• and
• a self learner, in communication with the fall out handler and the rules engine, the self learner to provide feedback to the rules engine based on information received from the fall out handler, the feedback being usable to resolve the issue associated with the incorrect claims adjudication, wherein the information received from the fall out handler is indicative of the issue associated with the incorrect claims adjudication.

A computer-implemented method, executed by at least one processor, the method comprising:

• processing claim data to identify one or more claims that are to be adjudicated from amongst a plurality of claims;
• orchestrating adjudication of the identified one or more claims based on the claim data;
• adjudicating the identified one or more claims based on pre-defined rules;
• determining if any of the identified one or more claims are incorrectly adjudicated;
• identifying an issue associated with incorrect claims adjudication on determining that any of the identified one or more claims are incorrectly adjudicated;
• and
• generating feedback based on the issue associated with the incorrect claims adjudication, the feedback being usable to resolve the issue associated with the incorrect claims adjudication.