CLARA Analytics, a provider of artificial intelligence (AI) technology for insurance claims optimization, has launched two new AI-powered innovations: Risk Notes and Claim Event Indicators. These tools are designed to optimize claims workflows, reduce operational friction, and enhance strategic oversight, enabling claims management to shift from reactive to proactive identification of deviations and opportunities in real time.The new tools aim to address the operational challenges faced by claims organizations in leveraging data and analytics for performance and productivity. Unlike traditional retrospective file reviews, which identify issues after claims close through small sample sizes, Risk Notes and Claim Event Indicators continuously assess every claim throughout its entire lifecycle.”The insurance industry has relied on retrospective sample file reviews for far too long,” stated Heather H. Wilson, CEO of CLARA Analytics. “We are applying AI strategically to advance the industry. By taking a more proactive approach, powered by intelligence, every single claim can be handled more efficiently than before, with accuracy and precision. This is intended to save time, money, and reduce frustration.”These new tools are integrated into CLARA Triage, a system that assists teams in prioritizing specific claims and prompts recommended actions. CLARA Triage utilizes AI to streamline the management of claims that require attention while facilitating the processing of others that may not need additional intervention.Risk Notes: Explainable AI for Claims ComplexityRisk Notes offer AI explainability for claims management by providing dynamic narrative summaries that automatically decode claim complexity. These summaries update as new information enters the claim file. Instead of adjusters analyzing extensive claim notes or isolated data fields, Risk Notes synthesize structured and unstructured data into clear explanations of the factors influencing a claim’s risk profile. This enables adjusters to understand the “what” and “why” of a claim’s status, and subsequently, what actions are needed. For instance, in cases involving time limit or policy limit demands, Risk Notes highlight critical gaps and can escalate cases for management review. The system also offers reserve benchmarking insights based on historical data.Claim Event Indicators: AI-Powered Signals for OutcomesWhile Risk Notes clarify the “why,” Claim Event Indicators focus on the “when,” continuously analyzing claims for sophisticated data combinations that identify key turning points. These indicators detect critical milestones across the claim lifecycle, from early-stage events like first notice of loss and initial medical treatment to mid-stage developments such as return-to-work planning and treatment monitoring, and late-stage events including litigation, settlement, and maximum medical improvement. Built on advanced logic that automates decision-making for claim closure tactics, the system scans, classifies, and triggers alerts, allowing adjusters to focus on strategic claim resolution.Transforming Claims Operations Through IntelligenceThe combined functionality of Risk Notes and Claim Event Indicators addresses long-standing challenges in claims organizations by providing: Proactive Alerts: Timely notifications for claims requiring action, aiming to prevent delays and missed opportunities. Automated Intelligence: Reduction in manual oversight and administrative overhead through continuous, AI-driven assessments. Strategic Focus: Provision of data and insights for adjusters and managers to concentrate on priority issues requiring human judgment. Dynamic Adaptation: Models trained to recognize new patterns and risk factors, allowing the system to evolve with changing business needs.”We are not replacing human expertise — we are augmenting it with smarter tools that provide continuous oversight and strategic guidance. That is the purpose of this launch, and we will continue to advance AI innovation for the insurance industry,” added Wilson.CLARA Triage, including Risk Notes and Claim Event Indicators, is immediately available for workers’ compensation claims. Availability for auto and general liability claims is expected in the coming months.CLARA Analytics, founded in 2017 and headquartered in California’s Silicon Valley, operates as an AI as a service (AIaaS) provider. Its platform, CLARAty.ai, utilizes image recognition, natural language processing, and other AI techniques to extract insights from various claim-related documents. These predictive insights aim to provide claim professionals with augmented intelligence to reduce claim costs and optimize outcomes for carriers, customers, and claimants. CLARA’s customer base includes global insurance carriers, third-party administrators, and self-insured organizations.