Adaptional offers an AI‑powered platform that continuously audits every insurance claim in real time against a customizable, multi‑dimensional scorecard covering compliance, coverage, leakage, service quality, subrogation, and reserves. The system ingests data directly from existing claims systems such as Guidewire or Duck Creek without additional integration work, flags issues, surfaces recovery opportunities, and sends instant alerts to managers for immediate remediation.
Funding
Funding not disclosed
Founders
Product
Problem
Insurance carriers rely on manual quality assurance processes that sample only a small subset of claims, leading to missed compliance violations, coverage errors, and leakage that are often discovered too late. Random selection and delayed reviews prevent timely corrective action, resulting in higher loss ratios, regulatory fines, and inefficient use of manager time.
Solution
Adaptional provides an AI-powered platform that continuously audits every claim in real time against a customizable scorecard covering compliance, coverage, leakage, service quality, subrogation, and reserves. The system ingests data directly from existing claims systems such as Guidewire or Duck Creek without requiring a separate integration project. As each claim is processed, the AI flags issues, surfaces recovery opportunities, and sends alerts to managers, enabling immediate remediation. By automating the review workflow, insurers can reduce overpayments, avoid regulatory penalties, improve indemnity accuracy, and free up staff to focus on higher‑value tasks.
Target Audience
Primary customers are property and casualty insurers, including claims operations teams, underwriting managers, and loss control departments that need comprehensive, real‑time claim quality oversight.
Features
- Seamless data ingestion from major claims platforms (Guidewire, Duck Creek) and any file‑based source, eliminating integration overhead
- Configurable, multi‑dimensional scorecard that evaluates compliance, coverage, leakage, service quality, subrogation, and reserves for every claim
- Real‑time AI analysis that continuously monitors claims and generates instant alerts for identified issues
- Dashboard and alerting system for managers to track open issues, ensure resolution, and monitor performance trends
- Automated identification of overpayments, missed deductibles, and subrogation opportunities before statutory deadlines
- Continuous monitoring of reserve adequacy and detection of stale or insufficient reserves