Advancing Claims Decisioning:'s Pioneering Solution that Leverages AI and Big Data

By David Thompson

Jul 18, 2023 04:27 PM EDT (Credit: Getty Image)

In the era of digitalization, industries across the spectrum are adopting emerging technologies to enhance their processes. Artificial intelligence and big data are at the forefront of this technological revolution. Insurtech is no exception, and leading the charge is, an insurtech startup aiming to revolutionize the insurance industry's claims processing. 

Historically, the insurance industry has been wrestling with the complex and time-consuming process of claims management. Diligence and consistency are crucial, yet maintaining efficiency has been an uphill task. That's where steps in with an innovative approach that harnesses artificial intelligence (AI) and big data to streamline claims decisioning.'s platform enables insurers to harness AI-guided Claims Insights in order to see claims from a whole new perspective. acts as the 'fourth lens' in insurance claim review. While the traditional lenses of claimant information, employer data, and medical provider details have long been in use, introduces a complementary perspective. It leverages AI to gather and analyze external evidence from thousands of publicly available data sources, providing insurers with valuable insights to expedite claim decisions. 

The company's AI-powered platform prioritizes claims based on feedback from the team, a testament to the power of machine learning. The more it learns, the more accurate and efficient it becomes at sorting and prioritizing high-priority claims. This use of machine learning serves to improve team efficiency and reduce costs associated with claims management. 

Moreover, the platform addresses one of the insurance industry's long-standing challenges - bias. By using an evidence-based system, aids in reducing potential bias in claims review, thereby enhancing the quality of decisions. This focus on reducing bias highlights the platform's value in transforming the insurance industry towards a more equitable model. 

The platform also enhances the claimant experience. By enriching claimant files and finding more fraud and malingering, it reduces claim durations and increases the likelihood of a claimant's return to work. Such an approach is particularly relevant today, given the increased scrutiny on insurers' practices and the demand for more transparency and fairness in the insurance process. 

Yet, while the technology is impressive, the platform's ability to scale is arguably its most significant advantage.'s platform can tap into a growing data network to collect the most accurate and relevant evidence. Such scalability allows insurers to keep pace with an ever-growing data universe without getting bogged down by processing limitations. 

At the helm of is seasoned tech entrepreneur Sean Merat. He believes in the potential of AI and big data to redefine the claims processing landscape. His vision is rooted in creating a

fairer, more equitable insurance experience, and his commitment to continuous learning drives the platform's constant evolution. 

In less than 3 years, has raised over $40M in financing along with millions in revenue from top insurers and partnered with some of the world's largest enterprises, proving the potency of Merat's vision and the validity of AI's role in revolutionizing the insurance industry. 

In an industry as established and resistant to change as insurance,'s innovative platform brings a breath of fresh air. It exemplifies the transformative power of AI and big data, propelling the insurtech industry forward and setting the stage for a more efficient and fair insurance claims process.

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