San Francisco, CA, March 26, 2024: EIS, a leading SaaS platform provider to the insurance industry, has today announced the launch of ClaimSmart, an intelligent cloud solution designed to redefine the claims management landscape. Leveraging the power of Artificial Intelligence and Machine Learning, ClaimSmart enables insurers to dramatically reduce the cost of claims, while significantly increasing the quality of the customer experience.

ClaimSmart drives down loss costs, by addressing key inefficiencies and waste drivers, such as redundant manual work, fraudulent claims, and claims leakage. In addition, its versatile and unified digital front-end portal ensures insurers can deliver fully digital customer experiences that prioritize self-service, cut friction, and make the full life-cycle more consumer-friendly and flexible.

“We’re proud to be one of ClaimSmart’s first users,” said Atsushi Wada, Claim Dept. Team Manager, Tokio Marine & Nichido Fire. “It’s helping to revolutionise our claims management process for both customers and employees. Inefficient and costly systems and process have been transformed, delivering faster resolutions, increased customer satisfaction, and large-scale operational savings.”

The launch of ClaimSmart represents a significant leap forward for EIS and an advancement in its expertise in data science. It lays the groundwork for a comprehensive Data Science (DS) suite of solutions, enhancing automation and efficiency across the insurance sector. The integration of DS methodologies is pivotal in developing algorithms that can analyze patterns, make predictions, and ultimately drive smarter, more efficient operations in the insurance industry.

Alec Miloslavsky, EIS CEO, said: “Claims platforms are in desperate need of transformation. It’s bogged down by manual tasks and ineffective processes that not only drive up costs but also degrade customer experiences. In response, we’ve developed ClaimSmart to address these challenges head-on.”

“Engineered to streamline operational tasks, ClaimSmart significantly alleviates tedious administration and enhances the digital front-end experience for customers. It ensures rapid processing of legitimate claims while minimizing claim leakage and the risk of fraud. This is a crucial expansion to our offerings, integrating ML and AI to enhance our platform’s capabilities and deliver a comprehensive end-to-end claim management solution.”

ClaimSmart is core-agnostic, allowing it to integrate seamlessly with most policy and claims management systems. When paired with ClaimCore, EIS existing claims system, ClaimSmart’s combined capabilities offer a holistic solution that accelerates claim resolution and delivers a customized and seamless experience for insurers and policyholders. This synergy is instrumental in reshaping the insurance claims operations landscape.

“With ClaimSmart, we’re embracing the transformative potential of data science to revolutionize insurance claims management. Our commitment to data fluidity, intelligence, and extensibility is crucial as we assist insurers in building their future ecosystems. This vision has been recognized by industry experts, such as Celent, who have named our Claims Platform a 2024 Tech Standout. As we continue to evolve our platform and collaborate with various insurtechs, our goal remains to deliver the best possible claims management outcomes, setting new standards in the industry.” said Miloslavsky.

ClaimSmart includes two products, ClaimPulse™ and ClaimGuard™. ClaimPulse introduces a new level of efficiency and technological sophistication utilizing digital first notice of loss (Digital FNOL), an automated claims processing layer, and integrated front-end digital portal. ClaimGuard is an AI and ML solution specializing in fraud detection and risk scoring that enhances the security and integrity of the claims process, and improves over time as it processes more claims.

Notes to Editors
ClaimSmart includes two products, ClaimPulse™ and ClaimGuard™.

ClaimPulse seamlessly integrates with existing claims processing systems such as EIS ClaimsCore and introduces a new level of efficiency and technological sophistication utilizing digital first notice of loss (Digital FNOL), an automated claims processing layer, and an integrated front-end digital portal.

Digital FNOL is the initial touchpoint and acts as a gatekeeper, streamlining claim initiation, and creating efficiency in downstream processes through reflexive questions and data-gathering based on claimant inputs and policy coverage. The advanced automation layer oversees the entire claims journey from initial report to final resolution. It’s equipped with a sophisticated workflow engine and library of foundational processes that drastically reduce the need for manual intervention, while minimizing errors to enhance operational efficiency.

The digital portal empowers customers to track the status of their claims in real time and take direct action, removing the need for time-consuming phone calls and lengthy hold, fostering a more direct and transparent communication channel. Customers can easily access information and updates, which significantly enhances their experience.

ClaimGuard is an AI and ML solution specializing in fraud detection and risk scoring that enhances the security and integrity of the claims process, and improves over time as it processes more claims. Using advanced analytics and machine learning algorithms, ClaimGuard meticulously analyzes each claim, identifying potential fraud risks and irregularities, while reducing leakage and ensuring legitimate claims are processed quickly.

It provides a nuanced risk scoring system, supporting insurers in making well-informed decisions. It ensures that legitimate claims are processed quickly, while significantly reducing the risk of fraud. ClaimGuard’s proactive approach in safeguarding the claims process upholds the highest standards of accuracy and trust in insurance transactions.

About EIS
EIS is a leading SaaS platform provider to the insurance industry and first choice for ambitious insurers building the customer-centric insurance ecosystems of tomorrow.

Our open, API-rich, event-driven architecture enables insurers to break free from inefficient, inflexible legacy systems and siloed organizational design, and enter a world where technology enables organizational excellence and world-class customer service.

Digital by design, EIS delivers the flexibility and agility needed to meet the dynamic demands of today’s modern insurance market, with the built-in adaptivity to orchestrate the transformations of the future.

Our cloud-native platform liberates insurers to enter new markets, develop new products, and build engaging experiences, while eliminating unnecessary costs, boosting retention, and delivering the self-sufficiency to accelerate your path to innovation, automation, and growth.

Headquartered in San Francisco, EIS is at the core of some of today’s most ambitious insurers. For more information, visit www.eisgroup.com.