AI-Driven Claims Management: CLARA Analytics and RAS
CLARA Analytics, a frontrunner in artificial intelligence (AI) technology for insurance claims optimisation, has secured a significant partnership with Risk Administration Services, Inc. (RAS). This collaboration marks a pivotal moment in the insurtech landscape, as RAS implements CLARA's product suite to improve its claims management capabilities.
CLARAty.ai: Claims Intelligence
At the core of CLARA's offering is CLARAty.ai, an advanced AI platform that harnesses the power of machine learning, predictive modelling, and natural language processing. This comprehensive solution encompasses five key modules: Claims DocIntel Pro, Triage, Treatment, Fraud, and Litigation.
Claims DocIntel Pro, a cornerstone of the CLARAty.ai suite, employs sophisticated AI algorithms to streamline document analysis. By automatically identifying, indexing, transcribing, and summarising claims documents, it enables claims professionals to rapidly review medical records and legal demands.
The system's ability to highlight crucial data points and generate concise summaries has resulted in a remarkable 33% reduction in document review time for some clients.
The Triage module leverages AI to prioritise claims effectively. By analysing vast datasets, it identifies claims requiring immediate attention and streamlines those less likely to need intervention. This intelligent sorting mechanism has demonstrated significant impact, with one mid-sized carrier reporting US$4.9mn in savings through improved claim segmentation and reduced litigation rates.
CLARA's Treatment module utilises AI to match claimants with optimal healthcare providers. The system analyses provider performance scores and employs predictive modelling based on extensive historical data from closed claims. This approach has yielded measurable improvements in return-to-work key performance indicators (KPIs) for multiple insurance carriers.
Jennifer Hertzfeld, Senior Vice President of Claims at RAS, says: "With CLARA, we can empower our adjusters with amazing insights so that they may repurpose their time on tasks that make the greatest impact."
Advanced Fraud Detection and Litigation Management
The newly deployed CLARA Fraud module represents a significant advancement in combating insurance fraud. The system utilises complex algorithms to examine intricate relationships between medical providers, legal counsel, and claimants across millions of workers' compensation claims. This sophisticated analysis enables the early detection of suspicious activity, allowing claims professionals to take prompt and appropriate action. CLARA's Litigation module is designed to minimise litigation risks through AI-driven analysis of tightly defined claim cohorts.
By making use of historical data and predictive modelling, the system provides insights into potential claim trajectories and offers settlement data to inform decision-making. The module's effectiveness is evident in its track record, with one client reporting a US$16mn reduction in litigation rates and medical expenses.
Heather H. Wilson, CEO of CLARA Analytics, adds: "Generative AI and predictive modelling on one platform can transform claims processes, and we are thrilled to enable another leading organization to discover its capabilities through CLARAty.ai."
The adoption of CLARA's AI suite by RAS, a leading expert in workers' compensation insurance and loss mitigation management, is particularly noteworthy. RAS manages The Dakota Group (DG), the largest voluntary writer of workers' compensation in South Dakota and a significant player in the Upper Midwest. DG's "A" rating from AM Best and four consecutive years on the Ward's 50 list.
CLARA Analytics' impact extends beyond individual partnerships. The company's client base includes firms from the top 25 global insurance carriers, as well as large third-party administrators and self-insured organisations. Since its founding in 2017, CLARA has consistently delivered impressive returns on investment, with some clients reporting ROIs exceeding 500%.
The insurance industry's increasing embrace of AI-driven solutions like those offered by CLARA Analytics signals a paradigm shift in claims management. As carriers seek to improve operational efficiency, reduce costs, and enhance customer experience, the role of advanced AI technologies in claims processing is set to grow exponentially.
CLARA's success in improving claims outcomes through its comprehensive AI suite positions the company at the forefront of the insurtech revolution.
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