Clive is the first AI insurance claims adjuster that works on top of any claims management system (CMS) and accelerates claims processing to unprecedented levels.
Clive’s revolutionary capabilities leverage the power of artificial intelligence and automation to redefine how claims are handled by insurers, MGAs, and TPAs, setting new benchmarks in efficiency, accuracy, and cost reduction.
Clive can do a lot on its own, from analyzing a new claim and checking coverage, through planning the claim handling process, and on to executing the different steps.
However, Clive can be implemented in many ways and is developed at its core to help human adjusters as a team player.
Clive frees up adjusters to concentrate on more complex aspects of claims handling, such as personalized customer care and communications and complex decision making, thereby enhancing overall productivity without displacing the valuable human element.
Human adjusters who own the claims handled primarily by Clive are therefore able to demonstrate superb processing results and enjoy more meaningful work.
Clive excels in orchestrating and automating tasks traditionally done manually by human adjusters. Clive’s capabilities span the entire claim lifecycle from first notification of loss (FNOL) through to settlement. Clive streamlines claims operations through automated document handling, exposure setting, automated communications with policyholders, and even real-time decision making according to the insurer’s guidelines. As a result, Clive allows for Straight-Through Processing in many cases or recommendations for human adjusters and claims managers on how to resolve a claim.
Clive operates by collecting and analyzing claim-related data, creating and executing tasks tailored to each stage of a claim's lifecycle, and dynamically choosing a course of action based on new information, communication, and claim-related events.
Clive ensures seamless interaction with policyholders, keeping them informed every step of the way.
Clive operates within the regulatory compliance environment and an insurer’s configurable boundaries. Clive applies any organizational policies and guardrails, while enabling flexible workflows that are more dynamic and effective than legacy rule-based procedures.
For situations that require judgment, exceptions, or when faced with complex issues, Clive consults with its colleagues (human adjusters and claim managers) ensuring that every claim is handled with utmost accuracy and efficiency.
Clive is included in Five Sigma’s claims management platform, but also available as a universal AI claims adjuster. We offer Clive’s advanced AI and automation capabilities on top of any Claims Management System (CMS) your organization is currently using, whether it’s Guidewire, Duck Creek, Sapiens, Majesco, or other.*
By utilizing your current system’s available APIs and webhooks, Clive extends its sophisticated automation and AI-driven insights across platforms, enriching your existing systems with its super-power Clive. This makes Clive a transformative tool for insurers seeking to leverage AI benefits without overhauling their existing claims infrastructure.
* Disclaimer: All CMS names and trademarks referenced are the property of their respective owners and are used for informational purposes only. Five Sigma has no affiliation with these companies and does not endorse any. Clive’s capabilities will depend on the limitations of your current system’s APIs. It will do its best given your system’s constraints.
According to many analyst reports, the future of insurance and claims management is poised for a significant transformation, driven by the integration of AI and automation technologies.
Five Sigma, an AI-Native claims management software company, realizes these predictions, at present time. With Clive, the insurance industry’s first AI-powered Insurance Adjustment Agent, we transform the claims processing landscape.
Clive’s revolutionary capabilities leverage the power of artificial intelligence and automation to redefine how claims are handled by insurers, MGAs, and TPAs, setting new benchmarks in efficiency, accuracy, and cost reduction.
