Introducing Clive™: The Insurance Industry’s First AI-Powered Claims Adjuster
PRESS RELEASE
Five Sigma, an AI-native claims management software company, is revolutionizing claims handling with a digital adjuster that works on top of any claims system and accelerates claims processing to unprecedented levels.
New York City, July 17, 2024 – In a groundbreaking move, Five Sigma, an AI-Native claims management software company, unveiled “Clive” ™, the insurance industry’s first AI-powered Insurance Adjustment Agent, designed to transform the claims processing landscape. Clive’s revolutionary capabilities leverage the power of artificial intelligence and automation to redefine how claims are handled by insurers, MGAs, and TPAs, setting new benchmarks in efficiency, accuracy, and cost reduction.
AI is poised to transform the Insurance Industry
According to many analyst reports, the future of insurance and claims management is poised for a significant transformation, driven by the integration of AI and automation technologies.
- According to a report by Accenture, “AI and automation are expected to enhance operational efficiency and customer satisfaction in the insurance industry. Automation can reduce manual labor and errors, leading to operational cost savings of up to 30%.”
- Gartner predicts that by 2025, AI and automation will streamline claims processing, reducing cycle times by 50% and improving customer satisfaction scores by 25%.
- Forrester Research indicates that Insurers are increasingly turning to AI and automation to provide personalized services and enhance the customer experience throughout the claims journey.
- A Deloitte report states that the adoption of AI technologies will enable insurers to leverage predictive analytics for improved risk assessment and fraud detection, resulting in cost savings and better compliance.
Overall, AI and automation are set to redefine the insurance and claims landscape, marking a new era of innovation and efficiency in the industry.
Five Sigma customers have been reaping the benefits of AI and automation for years.
Founded in 2017 as an AI-native software company, Five Sigma has been at the forefront of integrating artificial intelligence and automation into its claims management platform for years. Five Sigma is harnessing its deep claims expertise and the power of AI from its inception, enhancing efficiency, accuracy, and customer satisfaction for its dozens of customers: carriers, MGAs, TPAs, and self-insured companies.
Now, with the introduction of Clive, Five Sigma is making AI-powered claim handling a reality, not only for its own Claims Management platform, but also on top of any Claims Management System (CMS), allowing claims teams to benefit from AI and automation without replacing their existing claims system.
Clive represents the culmination of years of innovation and expertise, embodying the company’s commitment to pushing the boundaries of excellence in claims management. Through Clive, Five Sigma brings the future of insurance to the present.
Introducing Clive, an AI Claims Adjuster and a Team Player
Clive represents a major leap in claims management, embodying Five Sigma’s “Automation-First” approach. “We’re relying on data and computer algorithms as the default for claims handling and turning to human smarts and decision-making only when necessary,” says Gil Nechushtai, Five Sigma’s VP of Product. “We’ve developed Clive as the embodiment of this approach, leveraging our proprietary expertise and taxonomy in claims automation and enabled by the latest AI and LLM technologies.”
As an AI-powered insurance adjustment agent, Clive excels in orchestrating and automating tasks, traditionally done manually by human adjusters, across lines of business and tailored to specifics of the organizational Standard Operating Procedure (SOP). His capabilities span the entire claim lifecycle from initial loss notification (FNOL) through to settlement. Clive streamlines claims operations through automated document handling, exposure setting, personalized communications with policyholders, and even real-time decision making that allow Straight-Through Processing or recommendations for human adjusters or claims managers.
Clive operates by collecting and analyzing claim-related data, creating and executing tasks tailored to each stage of a claim’s lifecycle, and dynamically adjusting actions based on new information, communication, and claim-related events. Additionally, it ensures seamless interaction with policyholders, keeping them informed every step of the way.
At its core, Clive is developed as a powerful assistant to human adjusters, meticulously engineered to augment their work by automating time-consuming tasks. This approach frees up adjusters to concentrate on more complex aspects of claims handling, such as personalized customer care and making decisions, thereby enhancing overall productivity without displacing the valuable human element. Human adjusters who own the claims handled primarily by Clive are therefore able to demonstrate superb processing results and enjoy more meaningful work than what adjusters’ are usually used to, dealing with a lot of repetitive tasks under constant pressure.
Clive operates within the regulatory compliance environment and a customer’s configurable boundaries. Clive applies any organizational policies and guardrails, while enabling flexible workflows that are more dynamic and effective than legacy rule-based procedures. For situations that require judgment, exceptions, or when faced with complex issues, Clive consults its colleagues – human adjusters and claim managers – ensuring that every claim is handled with utmost accuracy and efficiency.
A Universal AI Add-On for any CMS
While Clive is included in Five Sigma’s claims management platform, the company decided to release it as a universal claims agent. Clive offers its advanced capabilities as an enhancement to any Claims Management System currently in use, whether it’s Guidewire, Duck Creek, Sapiens, or Majesco.
By utilizing available APIs and webhooks, Clive extends its sophisticated automation and AI-driven insights across platforms, enriching existing systems with its innovative features to the extent possible by the systems’ API limitations. This adaptability makes Clive a transformative tool for insurers seeking to leverage AI benefits without overhauling their existing claims infrastructure.
Building on a Strong AI and Automation Reputation
Customers of Five Sigma are not surprised by the announcement of Clive. “We saw it coming,” says Marc Rothchild, Senior Vice President and Head of Claims at Xceedance, an early adopter of Five Sigma’s platform. “With Five Sigma’s existing AI and automation features, we’ve already slashed manual, administrative tasks that traditionally take over 30% of an adjuster’s time, significantly boosting our operational efficiency and reducing Loss Adjustment Expenses. The introduction of Clive was eagerly awaited. Our adjusters already trust Five Sigma’s platform with the accuracy of its automation and its data-driven recommendations. Utilizing our guidelines and under our supervision, we anticipate Clive will unlock even greater benefits, elevating our claims management process to new heights.”
Oded Barak, Co-founder and CEO of Five Sigma, said “Clive is more than innovation, it’s a revolution in claims management, marking a significant milestone in our company’s journey towards claims management transformation. Clive acts as a proficient and effective claims adjuster. It’s a testament to our commitment to driving the insurance industry forward with AI and automation, demonstrating that the future of claims is here and now. We’re empowering our customers, and the insurance industry, to achieve unparalleled efficiency and greater customer satisfaction.”
About Five Sigma
Five Sigma is a revolutionary SaaS cloud platform that brings immediate improvements to the claim management process: expediting time to first contact, reducing cycle time, improving time to settlement, and reducing claims processing cost.
Designed by claims professionals and technology experts, Five Sigma offers an AI-native claims platform that streamlines every step of the claims process. With full visibility of the claim at a single place, advanced automation, and data-driven insights, Five Sigma empowers adjusters to excel, speeding up claims handling and improving policyholder satisfaction.
For insurers, MGAs, and TPAs, Five Sigma is a risk-free solution that unlocks unprecedented benefits quickly. Five Sigma is a future-proof platform that is always up to date for the benefit of all its customers, enabling them to adapt swiftly to market changes ahead of the competition.
For more information, visit Five Sigma’s website: https://fivesigmalabs.com/Clive/
Watch the Clive launch video here: https://youtu.be/c8tIGajB1ts