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Claims Management Solution

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Overview

Five Sigma is a cloud-native, data-driven Claims Management Solution (CMS) with embedded AI/ML capabilities to allow intelligent claims processing for the insurance industry. Five Sigma optimizes claims management by adding automated claims processing workflows, using data modeling and AI to provide smart recommendations, improving adjuster's decision-making, and reducing errors. Leading Insurance carriers, InsureTech, TPAs and Self-Insured companies use Five Sigma's CMS to modernize their Claims Management operations, reduce claims leakage, enhance compliance and improve their customers’ experience

Key Features

  • Automation - our proprietary automated workflows remove the burden of repetitive tasks, freeing your teams to focus on helping customers, while being compliant. Including:

    • Automated capture of all the communication related to the claim, including emails, phone calls, diary, notes and calendar, using natural language semantic and sentiment analysis.

    • Automated claims processing with integrated workflow, including adjuster assignment, claims routing, reminders and more

  • Smart recommendations - from straight-through claims to complex injury claims, the Five Sigma engine helps you make the right decisions on every claim, at every stage

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  • Company wide insights - With our unique data sets and analytics, you can see how your company operates as a whole, understand your risk and reduce claims leakage

  • Easy Integrations with 3rd party vendors like fraud, government systems and regulations, payments, assessments and more

  • Cloud based - Our system is fully SaaS - we provide quick time to deploy (weeks instead of months) and endless agility

Key Benefits

- Reduce claims leakage - automated workflows reduce claims processing times and eliminate human errors

- Compliance - automated workflows and recommendation mechanism ensure full compliance

- Customer satisfaction - shorter claim processing time, quicker time to resolution, providing visibility to the insurer

Product/Service details