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Claims Automation & Fraud Detection
AI & machine learning to stop claims leakage & build customer trust
With most solutions you have to choose between fraud prevention and a quick, seamless customer experience. With ClaimSmart™ you don’t have to choose – you can combat fraud while providing your customers with the personalized, efficient experience they crave.
Why ClaimSmart?
Catch more fraudulent or overstated claims with the robust fraud detection and risk assessment of ClaimGuard™. (And without adding resources or slowing down the claims process!)
Powered by AI and machine learning algorithms, it constantly enhances its ability to identify concealed issues in the ever-changing landscape of fraud.
By leveraging machine learning and advanced analytics, ClaimGuard thoroughly analyzes numerous potential scenarios associated with each claim and assigns risk scores accordingly.
Each claim is continuously assessed based on hundreds of scenarios and data points, detecting fraud with industry-leading accuracy. As it makes determinations, it records the factors and outcomes, continuously refining its fraud detection capabilities. Simultaneously, in the background, ClaimCore™ (or your preferred claims management system) processes precise settlement and payouts.
Driven by AI and ML, ClaimPulse™ revolutionizes claims automation with heightened efficiency, future-focused technology, and dependability to both insureds and carriers.
It lets you maximize every customer touchpoint, starting with digital first notice of loss. Insureds initiate claims through a user-friendly digital interface and can track real-time claim progress, while providing more information when necessary.
With this, you can also personalize claims-based interactions, building trust in your organization and maximizing your resources.
The automation layer incorporates multiple pre-configured processes to eliminate manual work, like arranging car rentals following accidents. This reduces the workload of claims examiners and expedites payout.
ClaimCore® & ClaimGuard™ Separately Recognized as 2024 Technology Standouts
“ClaimCore stands out for its technical architecture, including the modern code base, API integration, and ease of client-side configuration. But it’s no slouch functionally either, with fraud detection, litigation, and subrogation capabilities available out of the box alongside an intuitive user interface. This makes it a good choice for personal lines insurers of all sizes looking for a robust solution to claims management.”
- Nathan Golia, Senior Analyst, Celent
“We’re proud to be one of ClaimSmart’s first users. It’s helping to revolutionise our claims management process for both customers and employees. Inefficient and costly systems and process have been transformed, delivering faster resolutions, increased customer satisfaction, and large-scale operational savings.”
Atsushi Wada, Claim Department Team Manager, Tokio Marine & Nichido Fire
How do Insurers use ClaimSmart?
ClaimSmart makes it easy to improve the entire claims process — for you and your customers.
Through proprietary fraud detection, easily-configured customer experiences, and automated workflows, the combination of ClaimGuard and ClaimPulse is revolutionizing the claims journey.
Repair & Settlement
After the claim intake and fraud scoring process, the customer will automatically receive all of the information they need throughout the repair process, including automatic payment issued to the shop.
Non-Repair, Payment Preference, and Payment
Gathering pictures, sending an estimate, and facilitating a payment used to be a heavily manual process, but not with ClaimSmart. This tool facilitates the automated information gathering, verification of policy details, and payment, all while keeping your customer informed at every step of the process.
Let’s build a better claims process
If you can dream it, we can help you build it. Our team will work with you to identify areas of opportunity, integrate with your preferred platforms, and streamline your claims process.
Learn more about ClaimSmart
Make claims your claim to fame.
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Eliminate redundant manual work and boost fraud detection
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