The vast majority of insurance claims are mediated by physical claims handlers working over the telephone or with forms, referring back to processes from the 1980s. It can be slow, frustrating and expensive to deliver.

Insurance clients often have to fill in claim forms and provide documents supporting their claims. These claims would then be reviewed by a handler, the handler would review the form and pass or fail it based on its contents, often as part of a back-and-forth with the customer. This process causes significant amounts of customer dissatisfaction within the industry. Typically handling times vary depending on skill and workload, often with delays for busy periods, and there would also be additional process steps to check, for example, invoices for expected costs.

Wave Claims largely eliminates delay while delivering great claims experiences for the customer at a price point for the insurers 75% below the cost of the legacy process. Wave Claims gives you ClaimsOS, an operational AI-delivered claims management tool, with real-time claims decisions. It takes multiple data sources, pictures, and documents in different formats, (soon even speech), and uses it to create the claim form and check the validity of the claim.Wave Claims supports the customer in making their claim and then compares their inputs with the supporting policy as well as other relevant information such as expected cost. The process is completely scalable and works in real-time.

How it works

Wave Claims interprets the client’s documents to prefill the claim form and then interprets the claim as made against the underlying policy. If the claim is appropriate Wave Claims then checks claim costs against background information. The policyholder can receive a decision on the claim immediately and, if appropriate, immediate restitution. Wave Claims is live with two clients, both medical insurers, one in Germany, and the other in Switzerland.

Why we selected Wave Claims for ITC DIA Europe Amsterdam

AI technology will transform the insurance industry’s technologies and the customer service issues that are associated with it. As a scalable and effective technology to support claims, AI will enable incredible product innovation at the same time as reducing the legacy costs of manual claims processing.

At ITC DIA Europe, David Stubbs, Head of Claims, presented Wave Claims’ product ClaimsOS, which is the first live AI-claims-decisioning solution, and explained that AI claims are not simply about replacing people, but instead about enabling a complete change in the way insurers respond to their customers’ problems.

Who is Wave Claims?

Wave Claims is launched by a group of serial entrepreneurs including tech, finance and the insurance industry. Key people include (fltr): Patrick Dawson, Co-Founder & Managing Partner, Antonio Agudo, Co-Founder and Managing Partner and David Stubbs, Co-Founder and Head of Sales.

We each had a list of what was ‘wrong with claims’, each time we looked at how to solve these issues the answer was always AI.

Learn more on their website