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.
Like Clive™, the insurance industry’s first AI Claims Adjuster. Clive is a scalable, configurable, and insurance-savvy AI adjuster, offering a clear, actionable list of benefits designed to enhance your workflow, save time and money, and boost efficiency and accuracy.
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 decide how much Clive will automate for you and how much oversight you want over every action!
Clive transforms unstructured incident details (like emails, voicemail, chats) and policy documents into coherent First Notice of Loss (FNOL) reports.
Once structured, Clive jumpstarts the claim: automatically assigns adjusters to a claim, sets reserves, and sends appropriate communications.
Clive accelerates the initial claim intake process, reducing manual data entry errors and ensuring immediate action on new claims.
Clive analyzes claim and policy data to provide recommendations on exposure creation, ensuring accurate and comprehensive claim handling.
Clive enhances accuracy in identifying all potential exposures early in the claim lifecycle, minimizing overlooked liabilities and improving claim outcomes.
Clive assesses claim and policy data to recommend triage actions for claims and exposures, helping prioritize cases based on urgency and complexity.
This assessment optimizes resource allocation by focusing attention on high-priority claims, reducing cycle times, and improving efficiency.
Clive evaluates claim and policy information to provide recommendations on coverage decisions, reducing the risk of coverage errors.
Clive’s accurate recommendations ensure accurate, data-based and fair claim settlements, enhancing both compliance and customer trust.
Clive provides recommendations on damage assessments by analyzing claim details and documents, ensuring precise evaluation of losses.
Clive provides consistent, accurate damage evaluations, often eliminating the need for external assessors.
Clive analyzes data to suggest liability decisions, helping adjusters determine responsibility with confidence.
Clive’s analysis enhances decision-making accuracy in liability determinations, potentially reducing litigation costs and settlement times.
Clive applies reserving models (internal or third-party) to recommend or automate initial reserves and updates throughout the claim lifecycle.
Clive’s recommendations improve financial accuracy by setting appropriate reserves, supporting financial planning and ensuring regulatory compliance.
Clive detects inconsistencies across claims by analyzing claim attributes, financial patterns, and involved parties, providing indicators for potential fraud or Special Investigation Unit (SIU) referrals.
Clive helps identify potential fraudulent claims early, reducing financial losses and enhancing fraud prevention measures.
Clive automates indemnity and expense payments, from document review to approval through smart document processing (invoices, damage assessment documents) and process automation.
Clive streamlines the payment process, reducing delays, improving accuracy, and enhancing customer experience.
Clive classifies, analyzes, summarizes, and highlights key information in received documents, improving accessibility and understanding.
Clive improves the daily workflows of adjusters and their managers by reducing manual document handling accelerating information retrieval, helping advance claims faster.
Clive provides advice for claims adjudication tailored to the insurer’s Standard Operating Procedures (SOP) via an easy to use chat interface.
He recommends next actions, monitors SLAs, and ensures workflows follow SOPs — boosting consistency, compliance, and outcomes.
Clive drafts and automates communications throughout the claim’s lifecycle, such as acknowledgment letters, updates to third-party service providers, and status notifications for policyholders.
Clive reduces administrative workloads, and makes sure claimants receive tailored, timely responses.
Clive automatically manages notes and notifications across the entire claim workflow, using semantic search to enhance documentation accuracy and ensure regulatory compliance.
He fosters better collaboration among team members by providing a unified, real-time view of all claim activity.
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.
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.
Browse our blog posts for the latest insights and trends in claims management.
