Insurance Claims Analysis Platform
An AI-powered claims analysis engine enabling rapid triage, accurate payout predictions, and automated fraud detection.
The Challenge for Finity
Finity needed a highly accurate technological solution to address massive operational bottlenecks in insurance claims processing. Human adjusters were bogged down by straightforward claims while struggling to contextualise sophisticated fraud patterns buried in massive datasets. They required an automated, intelligence-driven analysis engine to triage incoming claims and predict likely payout exposures instantly.
The Solution
iMSX partnered closely with Finity actuarial teams to architect an AI-powered Claims Analysis engine. We utilised machine learning models trained on millions of historical records to create a dynamic risk-scoring heuristic. This allows the system to instantly fast-track low-risk claims for immediate automated payout, while securely flagging complex or potentially fraudulent outliers to human adjusters via an intuitive investigation dashboard.
Project Overview
- Identified quality issues across a significant portion of claims
- A quarter of all claims processed are likely lead to hard leakage