Agentic AI Technology Purpose-Built
for Claims Management

Clive™ orchestrates a suite of AI agents adding intelligence and automation across the full claims lifecycle.

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Get Five Sigma's CMS with Clive

Replacing or modernizing your claims system? Clive AI comes native inside the Five Sigma claims management platform from day one.

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Add Clive to your existing CMS

Deploy Clive, together with the workflows and system of action needed to carry its recommendations through to execution, on your existing claims system.

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Enabling the world's leading claims organizations

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See measurable results from day one

Real outcomes reported by claims teams running Clive today.

2X faster

claims handling

70% fewer

errors across the
claims lifecycle

Millions 
saved

on litigation and
expert costs

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15% lower

QA & compliance costs

33% boost

in adjuster productivity

30%
 reduction

in claims costs and LAE

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Start with the AI Agent you need most and expand as you go

Deploy one, several, or all - Clive scales with your operation.

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Clive™ Intake

Reduces errors and accelerates claim initiation by up to 75%, enabling faster, cleaner downstream handling.

  • 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 with human validation step

Clive™ Triage

Accelerates cycle time by prioritizing and assigning the right expert, cutting delays and reassignments by up to 35%.

  • 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

Eliminates manual policy checks, reducing human error by up to 70%.

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

Clive™ Liability

Improves accuracy in liability decisions, lowering indemnity and litigation exposure by up to 10%.

  • 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

Cuts document handling time by 50%, boosting adjuster productivity by up to 33%.

  • 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

Drives faster claim progression and consistency, reducing cycle time and leakage by up
to 40%.

  • 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™ Chat

Answers any claim-related question in seconds, saving up to 20 hours per claim.

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

Clive™ Insight

Reduces claim handling time by up to 35% and cuts errors by 25% through context-aware, SOP-aligned recommendations.

  • 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™ Comm

Cuts email handling time by 50%, boosting service levels and adjuster efficiency.

  • 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

Clive™ Risk

Reduces fraud exposure and flags high-risk claims early, saving millions in leakage and disputes.

  • 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™ Inspection

Cuts QA and compliance review time by 40-50%, with 100% coverage — improving audit readiness across your book.

  • 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

Clive™ Portfolio

Delivers cross-claim insights, prioritization, and recommendations to help teams focus on what matters most.

Clive benefits for claims operations teams

Five Sigma benefits for
claims operations teams

Request a DemoSee How It Works

Our Three-Layer Architecture for AI-Driven Claims

AI & Automation

Autonomous and self-learning AI agents that act, not just recommend, across the claim lifecycle.

Data & Integrability

APIs, webhooks, and built-in integrations that turn raw and unstructured data into AI, automation and connectivity fuel.

Claims Excellence

Transition from human-centric workflows to AI-driven, acting as the system of record & exception handling.

Our Three-Layer Architecture for AI-Driven Claims

Clive combines multiple AI models - not a single chatbot - to orchestrate claims handling end-to-end

AI & Automation

Autonomous and self-learning AI agents that act, not just recommend, across the claim lifecycle.

Automation-First Approach

Automates triage, coverage and liability validation, reserve calculation, vendor and payment workflows, compliance checks, and communications.

Claims Excellence

Transition from human-centric workflows to AI-driven, acting as the system of record & exception handling.

AI built for every claims leadership role

Real-time visibility, control, and audit-ready data - without adding headcount

Chief Claims Officer

Real-time visibility into claim trends, financial impact, and operational efficiency.

Claims Team Leaders

Workload distribution, adjuster performance, and customer satisfaction in one view.

Claims QA Managers

Compliance, leakage reduction, and audit-ready quality control.

Reinsurers

Structured claims data and insight to assess risk exposure and manage portfolios.

Ensure Claims Quality with Clive

Closed File Review

Automated Q&A-based file review - no crucial detail overlooked.

Open File Review & Monitoring

Flags claims that deviate from expected patterns before they escalate.

Compliance Control

Automated, proactive compliance checks at every step of the claim.

Security & Compliance Built for Enterprise-Grade Scrutiny

Clive is SOC 2 Type II certified and compliant with GDPR, HIPAA, and CCPA.

Reduce leakage
and costs
SOC 2 Type II (audited annually by EY), GDPR, HIPAA, CCPA
Access Control
RBAC, API keys, OAuth, SAML
Infrastructure
Google Cloud Platform - US, UK, EU, Australia
Testing
Annual third-party pen-testing + 24/7 monitoring
Encryption
AES-256 at rest
AI Data Handling
Built on Vertex AI / Gemini - no training on your data
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What Our
Customers Say

Clive gave us measurable gains on paper, but more importantly, it unlocked momentum. We’re seeing faster responses, more streamlined workflows, and a clear path to scaling operations without scaling costs. This also allows our team to dedicate more time to complex issues, driving better outcomes for our customers. That's the definition of real business impact. I’m excited to keep pushing the boundaries of what we can achieve operationally with these capabilities.
Marc Mercer Director of European Claims, INSHUR
Clive’s ability to quickly analyze and summarize complex data frees our team to focus on the decisions that matter most. It’s a powerful complement to human expertise, particularly in an industry like ours where the guest and employee experience is always the top priority. We’ve already seen how Clive enhances our efficiency and scales with our needs, while improving the quality of our outcomes. Our adjusters praised Clive’s ability to create helpful summaries, generate insights, and surface relevant information quickly. As the team’s lead and an executive at Resorts World, I can’t stress enough Clive’s direct impact on our bottom line.
Mark Habersack Executive Director of Risk Management, Resorts World Las Vegas

What's New at Five Sigma

FAQ

What is Clive AI?
Clive is the insurance industry's first multi-agent AI claims expert, built by Five Sigma. Rather than a single chatbot, Clive coordinates a suite of specialized AI agents that handle every stage of a claim - intake, triage, coverage, liability, communications, fraud detection, and settlement.
How does Clive AI work?
Clive uses a compound AI architecture that combines natural language processing, machine learning, computer vision, and predictive analytics. It integrates with your existing systems through an API framework, so it can read incoming claims data, apply automation to routine tasks, and hand off decisions to adjusters with full context and explainability.
Is Clive AI secure and compliant?
Yes. Clive is SOC 2 Type II certified and compliant with GDPR, HIPAA, and CCPA, with annual audits by EY, AES-256 encryption at rest, and infrastructure hosted on Google Cloud across four regions.
Does Clive replace my existing claims management system?
No. Clive is designed to work on top of any claims management system, so you can add AI to your claims operation without disruption or downtime. Insurers building a new CMS from scratch can also get Clive natively built into the Five Sigma platform.
What insurance companies use Clive?
Clive is live at carriers, MGAs, TPAs, and self-insurers around the world, including INSHUR, Resorts World Las Vegas, Xceedance, Quartz Claims, and Fast Cover.

Ready to see why leading insurance providers, MGAs, TPAs and self-insurers choose Five Sigma?

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