Transforming Life Insurance Claims with Proven AI Solutions

The amaise agenticAI Platform is revolutionizing the management of life insurance claims. Designed specifically for the insurance industry, our platform delivers measurable improvements in efficiency, accuracy, and customer satisfaction:

84%

Increase in Efficiency

Streamline claims workflows with AI-powered automation.

Enhanced Understanding

Provide claims adjusters with deeper insights into medical, financial, and legal aspects of claims.

10%

Reduction in Claim Payouts

Optimize settlement processes while maintaining fairness.

The Challenges of Life Insurance Claims

Managing life insurance claims is a complex, resource-intensive process that presents several key challenges:

Extensive Documentation

Handling large volumes of unstructured data, including medical records, financial statements, death certificates, and legal documents.

Fraud Prevention

Detecting fraudulent claims, including falsified medical records, staged deaths, and financial misrepresentations.

Complex Claim Histories

Evaluating intricate medical histories, financial dependencies, and legal contexts requires a high degree of expertise.

Time Sensitivity

Policyholders’ families and beneficiaries expect swift and accurate resolutions during emotionally challenging times.

Multidisciplinary Collaboration

Claims often require coordination among adjusters, legal teams, medical professionals, and financial advisors.

Litigation Risks

Disputes over claim denials or settlement amounts can lead to costly litigation and reputational damage.

Life Claims in a nutshell

In life insurance claims, especially for Long-Term Care and Disability Income products, clear and complete documentation is key to determining eligibility and detecting potential fraud.

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These claims often mirror Workers’ Compensation cases in their complexity. Medical records must clearly establish the cause of death, extent of disability, or treatment history—especially when permanent disability or accidental death benefits are involved.

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Independent Medical Examiners (IMEs) may be brought in to assess claim validity. This involves reviewing historical records, interviewing claimants or families, and identifying inconsistencies.

our solution

The amaise agenticAI Platform and Product Suite

The amaise agenticAI Platform addresses these challenges with a comprehensive AI-driven approach to life insurance claims management:

Automatic Document Organization

Effortlessly organizes all claim-related documents—medical records, death certificates, financial statements, and legal files—while eliminating duplicates for streamlined workflows.

Key Fact Extraction

Highlights critical information such as cause of death, medical diagnoses, policy coverage, and financial dependencies, ensuring all relevant data is readily accessible.

AI-Powered Insights and Recommendations

Provides actionable insights for decision-making, including liability evaluations, settlement recommendations, and fraud risk assessments. Offers multiple perspectives—pro-insurance, pro-beneficiary, and neutral—for balanced decision-making.

Preconfigured Question Sets

Customizable templates ensure that each claim is evaluated thoroughly and consistently according to organizational standards.

Key Benefits

Optimized Claim Settlements

Ensures fair and accurate compensation while reducing the risk of overpayments or underpayments. Proven results include a 10% reduction in claim payouts, with significant cost savings anticipated for U.S. insurers.

Accelerated Claims Processing

Enhanced Fraud Detection

Litigation Risk Reduction

Why Choose amaise?

Proven Performance

Trusted by leading European insurers and currently being piloted by major U.S. life insurers, the platform delivers measurable improvements in claims handling.

Modern Tools

Secure Collaboration

Effortless Implementation