Veltha provides an AI platform that automatically extracts data from claim documents and verifies each claim against relevant regulations, supplying paragraph-level citations to prevent audit findings. Users can connect their claims system or upload files, and the AI agents flag compliance issues in real time, streamlining the adjuster workflow and reducing manual review effort.
Funding
Funding not disclosed
Founders
Product
Problem
Insurance adjusters must manually review each claim against complex, line‑specific regulations, a process that is time‑consuming and prone to human error. Mistakes can lead to audit findings, regulatory penalties, and increased claim costs.
Solution
Veltha offers an AI‑driven platform that ingests claim data from connected systems or uploaded files—including typed, scanned, and handwritten documents—and creates a unified claim view. The AI extracts relevant fields and automatically checks the claim against the applicable insurance regulations, flagging potential compliance issues with paragraph‑level citations. Reviewers can see each flagged item in context, approve or override decisions, and an immutable audit trail records the citation, reviewer, reasoning, and timestamp. This workflow reduces manual effort, improves regulatory adherence, and provides a one‑click response to regulator inquiries.
Target Audience
Primary users are workers’ compensation adjusters, claims managers, and compliance officers at insurance carriers and third‑party administrators who need accurate, auditable claim reviews.
Features
- Integration with existing claims management systems or file‑based uploads for seamless data intake
- Multi‑format document processing (typed, scanned, handwritten) using AI extraction to build a structured claim model
- Rule‑based AI agents that compare claim data to line‑specific regulations and generate paragraph‑level citations for each issue
- Reviewer interface that presents flagged items with full context, allowing approval or override with documented reasoning
- Comprehensive audit trail linking every decision to its regulatory source, reviewer, and timestamp for regulator queries
- Scalable cloud architecture designed to handle high claim volumes while maintaining low latency checks