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Why Insurance Claims are Broken?

Annual insurance fraud losses in the U.S.

$0B

Fraud, leakage, and missed claim details create major costs across the industry. Claims teams need better tools to catch issues early.

30%

Operational Inefficiency

Manual review = inconsistent decisions.
Claims involve payment inaccuracies.
Claims take weeks instead of days.
High operational cost per claim.

50%+

Financial & Customer Impact

Customers dissatisfied after claims experience.
P&C claims show fraud indicators
Poor claims = lost lifetime value
Commercial & health fraud.
Harder to spot manually.

So how do we fix this?

?

Grammarly for claims decisions, real-time AI that flags conflicts, prevents missed deadlines,and improves denial quality inside the adjuster’s workflow.

Speed
Customer satisfaction
Errors
Cost per claim

Real-Time Decision Guardrails

Flags contradictions in real time (e.g., IME after denial/exclusion) and prompts the right next step.

~40% higher accuracy

Timeliness + Compliance Autopilot

Builds a live claim timeline and alerts before deadlines are missed or actions become untimely.

24/7 auditing

Denial Language & Correspondence Co-Pilot

Reviews drafts for missing policy specifics and strengthens denial/reservation language, one click to apply.

Up to $10M/yr saved

Always-On Audit Trail + Learning Loop

Logs every alert and action for a defensible audit trail and improves recommendations over time.

Billions of signals

Why claims teams need better visibility

Manual review makes it easy to miss key details, delay decisions, and create costly rework. Clariom helps catch issues earlier.

0

Claims reviewed in real time

0

More visibility into missing details

0

Signals analyzed across the claim file

Product Evolution Roadmap

PHASE 01

AI COPILOT

2026

1. Real-time claim review
2. Flags errors & fraud
3. Explains fixes, enforces rules

PHASE 02

AI CLAIMS AGENTS

2027

1. End-to-end claim processing
2. Applies learned corrections
3. Escalates edge cases

PHASE 03

SMART CONTRACT INSURANCE

2027 - 2028

1. End-to-end claim processing
2. Applies learned corrections
3. Escalates edge cases

Product Evolution
Roadmap

PHASE 01

AI COPILOT

2026

1. Real-time claim review
2. Flags errors & fraud
3. Explains fixes, enforces rules

PHASE 02

AI CLAIMS AGENTS

2027

1. End-to-end claim processing
2. Applies learned corrections
3. Escalates edge cases

PHASE 03

SMART CONTRACT INSURANCE

2027 - 2028

1. End-to-end claim processing
2. Applies learned corrections
3. Escalates edge cases

Let's talk about your claims process

See how Clariom helps claims teams catch missing details, reduce leakage, and stay ahead of deadlines.

Clariom white and blue text logo

Clariom helps claims teams catch missing details, reduce leakage, and stay ahead of deadlines.

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