Smart Claims by SilverBridge is a cloud-based, AI-driven solution designed to automate and optimize the insurance claims process. The platform leverages artificial intelligence to model expert decision-making, enabling real-time claims processing with both internal and external risk scoring. This allows for straight-through processing (STP) of claims, reducing manual intervention and operational inefficiencies. Smart Claims integrates directly with insurers’ core business systems and third-party data sources, including government verification services, to ensure accurate and compliant decision-making. The AI models are continuously assessed and can be retrained and redeployed rapidly to adapt to market or regulatory changes, ensuring ongoing accuracy and relevance. By automating routine claims decisions, the solution frees staff to focus on higher-value tasks and improves both customer experience and risk mitigation.

Key Features

AI-Driven Decision-Making Automates claims assessment using advanced AI models.

• Virtualizes insurer expert decision-making
• Continuously retrained for accuracy and compliance

Real-Time Risk Scoring Calculates internal and external risk scores for each claim.

• Integrates with third-party data sources (e.g., government verification)
• Supports risk mitigation and fraud detection

Straight-Through Processing (STP) Enables end-to-end automation of claims.

• Reduces manual intervention and bottlenecks
• Accelerates claims resolution and payout

Seamless Integration Connects with core insurance systems and external data providers.

• Direct integration with line-of-business systems
• Supports ecosystem connectivity for comprehensive decision-making

Continuous Model Assessment Ensures AI models remain effective and up-to-date.

• Rapid retraining and redeployment with no business disruption
• Adapts to regulatory and market changes

Benefits

Operational Efficiency Streamlines claims processing and reduces manual workload.

• Automates routine decisions, freeing staff for complex cases
• Minimizes processing delays and administrative overhead

Improved Customer Experience Delivers faster, more accurate claims outcomes.

• Real-time processing reduces wait times
• Consistent, expert-level decision-making

Enhanced Enhanced Risk Management Improves detection of fraud and high-risk claims.

• Uses comprehensive risk scoring and external data checks
• Supports regulatory compliance and auditability

Business Agility Adapts quickly to new requirements and market conditions.

• AI models can be retrained and redeployed rapidly
• Scalable for different claim types and business sizes