Transforming Disability Claims Handling with Advanced AI Solutions

The amaise agenticAI Platform is revolutionizing the management of disability claims in the United States. 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, vocational, and legal aspects of claims.

10%

Reduction in Claim Payouts

Optimize settlement processes while maintaining fairness.

The Challenges of Disability Claims Management

Managing disability 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, such as falsified medical records or misrepresented disabilities.

Complex Claim Histories

Evaluating intricate medical conditions, vocational factors, and legal contexts requires a high degree of expertise.

Time Sensitivity

Claimants expect swift and accurate resolutions during challenging times.

Multidisciplinary Collaboration

Claims often require coordination among adjusters, legal teams, medical professionals, and vocational experts.

Litigation Risks

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

Disability Claims in a nutshell

Disability income claims often involve long-term conditions, functional impairments, and disputes around work capacity. Adjudicating these claims requires a detailed review of medical records, functional assessments, and often, input from multiple healthcare providers.

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Fraud risk is significant, and clarity is essential—especially in partial or permanent disability determinations. Independent Medical Examiners (IMEs) are frequently engaged to assess the claimant's condition and validate supporting documentation.

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The challenge? Available documention is often fragmented, unstructured, and time-consuming to review.

our solution

The amaise agenticAI Platform and Product Suite

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

Automatic Document Organization

Effortlessly organizes all claim-related documents—medical records, employment histories, legal files—while eliminating duplicates for streamlined workflows.

Key Fact Extraction

Highlights critical information such as medical diagnoses, vocational assessments, policy coverage, and compliance issues, ensuring all relevant data is readily accessible.

AI-Powered Insights and Recommendations

Provides actionable insights for decision-making, including disability evaluations, settlement recommendations, and fraud risk assessments. Offers multiple perspectives—pro-insurance, pro-claimant, 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. disability insurers, the platform delivers measurable improvements in claims handling.

Modern Tools

Secure Collaboration

Effortless Implementation