Use cases

We employ a holistic approach to the use of data and the claims process, starting from the past (legacy data) into the present (incoming claims/FNOL) and towards a digital future (fully automated claims settlement). This approach ensures superior training models that in turn maximize bespoke claims process effciency.

Porfolio audit
& insights



Automated Settlement (future)
pain point

  • Audits are labour
    intense and take a
    long time

  • Reviews on only a few
    randomly selected
    bring the fear
    that large hidden
    claims are not spotted

  • No real understanding
    of the portfolio
    what is in the
    structured data

  • Labour intense,
    typically scales with
    number of employees
    and their cognitive

  • Error prone because of
    human input

  • Only a few data points are stored
    in the system and thus available for analysis.
    other information
    from the communication is discarded

  • Validation of reservations and payments is
    manual, delayed,
    time-consuming and
    error prone

  • Significant leakage of
    overpayments because of lack of control

  • Error prone invoice
    capturing process

  • Delayed reserved
    adjustments and
    approvals for

  • Customer complains


  • Digitize the whole claims portfolio

  • Train AI models to spot over/ under reserved claims,
    unusual movement, potential fraud, inactivity etc., all worth a manual review

  • Reports summarizing portfolio review

  • Portfolio slice & dice reports per topic (i.e., per LoB, country etc.)

  • Keep all information searchable

  • Reduce the time humans spend
    on inserting information
    into the system

  • Spot critical claims

    early and triage

  • Topic Modelling ie Understand the Documents automatically,
    Claims Summary, Key
    Information Extraction, etc

  • Increase transparency and accuracy in the validation,
    reservation, and settlement process

  • Automated cross-checking of invoicing, statements, external data sets and reports

  • Automated reserve

  • Automated payment

  • Automated validation


  • Full portfolio claims
    reviews completed in days

  • 100% of clams reviewed

  • Fast remedial action based on findings

  • Improving reservations by identifying
    over and under reservations

  • Increase information accuracy

  • Proactive claims handling

  • Early detection of
    severe claims and cost of capital reduction

  • Reduced response
    time, manual intervention and leakage

  • Better claims journey for the customer

  • Faster release of
    outstanding reserves

  • Clerks focus more on
    H2H tasks

  • Improved customer
    satisfaction and