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Clive AI Agents
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Choose the AI Agents You Need, When You Need Them

AI Claims Handling – The Future of Claims Management is Here.

AI in claims management sounds promising. The answer to all your claims handling challenges:
time-consuming manual processes, hours spent sifting through documents, frequent policyholder contacts, slow claim lifecycles, and inaccurate resolutions.

AI promises to automate, accelerate, and elevate these processes, putting the focus on quality and customer success. Can it really perform all these magical tasks and improve every operation?

The answer is a resounding yes. But (there’s a but)—you need to choose the right AI.

Agentic AI Technology Purpose-Built for Claims Management

Clive™, the insurance industry’s first Multi-Agent AI Claims Expert is a scalable, configurable, and insurance-savvy AI claims expert, offering a clear, actionable list of benefits designed to enhance your workflow, save time and money, and boost efficiency and accuracy.

Clive manages multiple AI agents that handle and automate different tasks and claim stages, including intake, triage, liability assessment, coverage, communications, fraud detection, compliance, settlement, and more.

And the best part? Clive works on top of any claims management system (CMS)! You can add AI to your existing claims operations without any disruption or downtime. You can start with the Clive agents your operation requires and easily expand as your needs grow.

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Start with the AI agent your operation needs most, and add more as you grow.

Clive Supports the Entire Claim's Lifecycle from FNOL to Settlement

Clive™ Intake

    Clive accelerates the initial claim intake process, reducing manual data entry errors and ensuring immediate action on new claims. Clive transforms unstructured incident details from emails, voicemail, chat and documents into coherent First Notice of Loss (FNOL) reports.

  • Extracts and structures incident details from any type of unstructured data
  • Autonomously integrates with the policy system to retrieve and extract the necessary policy details
  • Generate complete FNOL reports to the downstream CMS that is fully automated or may have human-in-the-loop validation step

Clive™ Triage

    Clive analyzes incoming claims in real time, using an AI-driven severity scoring model to automatically triage and route each claim to the right adjuster or specialist. Clive ensures fast, consistent decisions at scale, assigning the right resource to the right task for the get-go while eliminating manual guesswork and reassignments.

  • Prioritizes claims based on severity, urgency, and complexity
  • Optimizes team workload by aligning claims with expertise
  • Handles surges in volume — no additional staffing required

Clive™ Coverage

    Clive runs a first-pass coverage check based on configurable criteria such as policy match, coverage in force at date of loss, and relevant exclusions. Clive ensures accurate, consistent and explainable data-driven coverage validation at scale, helping adjusters move confidently to the next stage of the claim.

  • Automates coverage validation against policy data
  • Integrates with the Policy Administration System (PAS) to retrieve policy terms and endorsements
  • Delivers faster, consistent coverage decisions and reduces leakage from misinterpretation
  • Facilitates auto denials

Clive™ Liability

    Clive determines liability using expert analysis and contextual reasoning, drawing from both structured and unstructured claim data. Clive accelerates liability decisions, enhances accuracy, and supports adjusters with contextual insights and explainability—unlocking recovery opportunities, reducing litigation risk and speeding up settlements.

    • Reviews documents, police reports, and communications to assess responsibility
    • Identifies liability patterns and contributing factors
    • Flags inconsistencies and recommends next steps for investigation
    • Integrates with internal claim records and external evidence sources

Clive™ Document

    Clive classifies, summarizes, and tags incoming documents across various formats, ensuring critical information is surfaced quickly. Clive streamlines document handling, saves valuable adjuster time, and improves visibility across the entire claim file.

  • Automatically processes PDFs, Word, Excel, images, voicemails and MSG files
  • Summarizes content and applies smart tags for easy search and context
  • Flags irrelevant or duplicate attachments to reduce clutter

Clive™ Planning

    Clive provides a context-aware, continuously updated action plan that guides adjusters through each step of the claim, ensuring progress, accuracy, and compliance. Clive helps adjusters stay focused, reduces missed steps, and drives consistent, traceable, professional and compliant claim outcomes.

  • Generates a dynamic claim plan based on coverage, liability, reserves, and SOP requirements
  • Suggests next best actions and updates the plan as new data becomes available
  • Keeps adjusters on track while ensuring full alignment with standard operating procedures

Clive™ Insight

    Clive proactively delivers actionable insights throughout the claim, based on real-time context and the insurer’s standard operating procedures. Clive empowers adjusters and managers with proactive, real-time, relevant guidance, enhancing decision-making and driving better claim resolutions.

  • Surfaces next steps, alerts, and observations tailored to your SOP and the claim's current status
  • Identifies bottlenecks, risk signals, and missed actions that are often overlooked
  • Aligns all insights with the SOPs to ensure consistency and compliance

Clive™ Chat

    Clive is your know-it-all claim expert—ready to answer questions, flag issues, and summarize content instantly. Clive gives adjusters instant access to answers, reducing clicks and cycle times, improving accuracy, and increasing confidence without changing workflows.

  • Web-based or in-app chat for asking questions about the claim file and any uploaded notes, communications or documents attached to it.
  • Handles expert-level document understanding (policy, legal, police reports, medical, invoices, correspondence)
  • Flags discrepancies across documents or within the broader claim context

Clive™ Risk

    Clive proactively detects fraud, anomalies, and authenticity issues across documents, images, and claim data—flagging risks early for proactive intervention. Clive acts as an always-on risk layer, helping adjusters and SIU teams spot issues faster, reduce leakage, and stay ahead of fraudulent behavior.

  • Identifies discrepancies within and across documents, forms, and uploaded files
  • Analyzes metadata, image forensics, and claim patterns to detect potential fraud
  • Flags suspicious activity and recommends further investigation

Clive™ Communication

    Clive automatically manages incoming communications; summarizing, classifying, and linking them to the correct claim, while drafting appropriate responses in real time. Clive cuts down on admin work, speeds up response time, and ensures every message is tracked, compliant, and handled the right way.

  • Summarizes and classifies emails, calls, texts, and chats
  • Associates each communication with the relevant claim, contact, and context
  • Drafts adjuster-ready responses that align with SOP and claim history
  • Works across all channels: voice, email, SMS, chat, and more

Clive™ Inspection

    Clive automates and scales quality assurance and compliance audits, reviewing claims against SOPs, regulatory standards, and internal benchmarks. Clive saves QA teams hours of manual review, increases audit consistency, and strengthens regulatory reporting across the board.

  • Reviews closed or in-flight claims for compliance with procedures, documentation, and regulatory rules
  • Auto-fills QA checklists and flags missing notes, inconsistent reserves, or deviations from expected workflows
  • Drafts adjuster-ready responses that align with SOP and claim history
  • Integrates with claim data, workflows, and SOP documentation

Choose Clive's AI Agents for YOUR Claims Team

Free Your Adjusters to Focus on What Matters Most

Watch what Clive Can Do

Seamless Deployment. Zero Maintenance Hassle.

Clive is live at many insurers around the world and fully configurable to your SOP and workflows using no-code settings. 

Five Sigma provides end-to-end support for every module integration, including calibration, accuracy testing, and maintenance. Clive and its AI agents are always up to date in their latest version, for the benefit of all customers, so organizations get all the benefits of new innovation with none of the upkeep hassle.

We’ll work with your Service Integrators, or offer our delivery services, to get Clive up and running as part of your claims operations within months!

Schedule a Clive Demo

AI Quality Control for Claims Leaders

Clive provides comprehensive quality control for every claim—open or closed—across your entire claims portfolio, enhancing oversight and analysis of each claim, facilitating improved quality control and decision-making processes.

Learn more about Clive’s inspection and QA

Watch A Mini Demo of Clive's Features

Clive streamlines multiple documents upload! Clive users can easily upload documents via the Clive chat interface, and Clive will automatically summarize and classify them, providing the name and type of the file. 

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More To Explore

Browse our blog posts for the latest insights and trends in claims management.

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FNOL Automation: How AI Agents Turn First Notice Into First Action

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Meet Clive!