Why Gradient AI for Claims Management?

Gradient AI offers AI claims products powered by one of the industry’s largest data lakes of claims data with tens of millions of claim records and their outcomes, enhanced with third party data and our own proprietary features. You get high performing models that improve claim predictions, enabling you to pursue better claim outcomes proactively.

Gradient AI can be easily integrated with existing platform solutions and processes, delivering AI at the point of decision to achieve the maximum business impact.



Workers' Comp Claims Solutions include:

Medical-Only Conversion

Gradient AI’s Medical-Only Conversion solution predicts which medical-only claims are most likely to convert to lost time/indemnity claims. This prediction can be delivered within a few days after a claim file is created and is automatically updated every time new data is added to the claim file. This enables supervisors to assign the correct type of adjuster and allows those adjusters to take actions today that may be unavailable later in the life of the claim.

Risk Ranking for Lost Time/Indemnity Claims   

Gradient AI’s Risk Ranking solution predicts which lost time or indemnity claims are most likely to exceed $50,000. This prediction can be delivered within a few days after a claim file is created and is automatically updated every time new data is added to the claim file. With this early warning, adjusters have the greatest opportunity to aggressively manage complex claims to reduce their severity.

Total Incurred Prediction

Gradient AI’s Total Incurred Prediction (TIP) solution predicts an expected range of the ultimate total incurred of each claim. This prediction can be delivered within a few weeks after the claim file is created and is automatically updated every time new data is added to the claim file. This prediction can be used for supervisor oversight, reserve audits, and settlement discussions. Use this product in conjunction with Open Claim Benchmarking (see below) for greater insights and interpretability.

Open Claim Benchmarking (Available only with TIP)

Gradient AI’s Open Claim Benchmarking solution uses patent-pending technology to put each open claim in context by displaying 100 similar historical claims, identified from among Gradient AI’s vast data lake of tens of millions of claims, to assess how those claims were reserved as of that same age. This illustration is further put in context by displaying the final total incurred of each of those historical claims, to show how they subsequently developed. Together, these different views allow a supervisor or adjuster to compare an open claim’s reserve to various benchmarks and adjust if warranted.

Legal Engagement

Gradient AI’s Legal Engagement solution predicts the likelihood that a claimant will retain a lawyer, thereby dramatically increasing cost, duration, and complexity. With this early warning, adjusters have a window of opportunity to adjust course, address claimant concerns, or settle a claim before a lawyer is engaged.

Learn how Gradient AI's solutions can benefit your organization. 

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