Claims
Run claims risk-based, in real time.
A productised AI workforce for Heads of Claims and Chief Claims Officers. Clara handles the full claims process from FNOL to settlement, escalating to a human expert only when expert judgement is what the case actually needs.
Claims is where insurance leaks margin
Volume keeps rising. Customer expectations keep rising. Fraud keeps rising. Headcount doesn't — and the people you do have are spending most of their time on triage and clerical work, not on the cases that need human judgement.
You can't hire your way out of this. You need to redesign the operation around what humans should actually be doing.
What Clara does
Clara is a productised orchestration agent for claims risk management. She manages risk assessment and decision-making across the insurance claims process from first notification of loss to settlement — and she's built to know when to stop.
Core capabilities:
FNOL triage and registration.
Capture, validate, classify and route every claim with full extraction from any input format — voice, web, app, document, email.
Risk-based decisioning.
Real-time assessment of complexity, fraud signal, severity, jurisdiction and policy fit. Confidence-scored. Escalation when judgement is required.
Settlement orchestration.
Calculate, recommend and execute settlements within your policy and authority structure, with full reasoning trace.
Loss Adjustment Expense optimisation.
Real-time treatment recommendations balancing total cost, queue time, clinical fit and proximity with service partners.
Counter-fraud signal.
Continuous fraud screening at the case level, flagged into your existing investigation workflow.
Active use cases
Personal-injury triage
Real-time treatment recommendations at FNOL. 75% acceptance rate, 0% hallucinations reported.
End-to-end claims risk management
Risk assessment and decisioning across the claims book, with full reasoning trace on every action.
How the business case looks
Claims leaders justify Clara on four lines:
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Cycle time.
Sub-minute FNOL processing. Same-day decisions on a high share of routine cases.
Leakage.
Consistent application of your policies, authorities, and reserve discipline — across every case, every shift, every region.
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Fraud savings.
Continuous screening at every case, not just at sampling.
FTE redeployment.
Move adjusters off triage and clerical work into the complex cases where their judgement actually pays for itself.
75% of recommendations accepted. 0% hallucinations reported. The agent escalates the cases where escalation is the right call.