Enterprise Claims
Intelligence Reimagined.
AI-powered and agentic claims operations that detect fraud, prevent leakage, and accelerate outcomes.
Platform-wide orchestration from intake to resolution.
Key Logic & Impact
- Detects fraud and prevents leakage in real-time
- Accelerates outcomes across the entire claims journey
- AI-driven next-best action prompts for adjusters
Integrates with Enterprise Core Systems
Structural Constraints.
Large insurers face systemic bottlenecks that incremental upgrades can no longer solve.
Claims Leakage
5–20% of annual claims value is lost to fraud, inefficiencies, and undetected errors, while recoveries remain capped by low audit coverage.
Manual Workflows
Auditors typically review only 20% of yearly fraudulent claims and recover about R100M from sampled audits.
Limited Visibility
Fragmented data sources prevent real-time exposure monitoring and accurate forecasting.
Rigid Legacy
High TCO driven by archaic systems and complex, fragile integration layers.
Claims Intelligence
Reimagined.
A fully integrated, enterprise-grade claims ecosystem designed for health, insurance, and national schemes.
Lifecycle Orchestration
End-to-end management from loss adjusters to multi-stage payment approvals.
Reserve & IBNR Intelligence
Real-time financial exposure dashboards and automated reserve modeling.
Fraud & Risk (AI Core)
Graph AI collision detection and real-time pre-payment risk scoring.