Eastern Alliance Insurance Group, a fully owned subsidiary of ProAssurance Corporation, has chosen the CLARAty.ai platform from CLARA Analytics, a provider of artificial intelligence (AI) technology for optimising insurance claims, to enhance claims management.
This platform will help improve medical outcomes for injured workers, increase the accuracy of reserves, and reduce the administrative workload for claims professionals.
CLARA’s claims intelligence platform combines their established predictive analytics with advanced generative AI (GenAI) capabilities to deliver a claims management solution.
The AI models process various data sources, such as claims data, notes, medical records, and legal documents. This analysis provides claims professionals with actionable recommendations for optimal next steps and proactive cost control strategies, helping to prevent claim escalation.
Eastern Alliance plans to utilise CLARA’s comprehensive platform to tackle the challenge of rising medical costs.
Their approach includes implementing several of CLARA’s key solutions: CLARA Optics for medical document intelligence, CLARA Treatment to direct care to top-performing medical providers, and CLARA Triage to prioritise high-severity claims early in the process.
“CLARA’s capability to deliver ROI through their AI platform truly distinguished them from the competition,” commented Kevin Shook, President at Eastern Alliance.
“We foresee considerable operational efficiencies and loss reductions that will create substantial value and reduce the manual workload for our claims professionals. Ultimately, this can result in savings for us and our insureds and help injured workers return to wellness and productivity faster. That potential makes this partnership a win-win for everyone involved,” continued Shook.
CLARA’s acclaimed AI platform is capable of analysing both structured and unstructured data, utilising natural language processing (NLP) and large language models (LLMs) tailored for insurance claims.
The insights generated assist claims professionals in making well-informed, data-driven decisions. CLARA’s customers consistently see impressive returns on investment, often surpassing 500%.
Heather H. Wilson, CEO of ClARA Analytics, added: “We are honoured that Eastern Alliance has chosen CLARA as their preferred claims intelligence platform. This partnership aligns perfectly with our mission to revolutionise claims management.”
“We look forward to supporting Eastern Alliance in their commitment to excellence, helping them deliver superior care to injured workers, streamline operations for their claims team, and ultimately achieve better outcomes for all stakeholders involved in the claims process.”
Workers’ compensation claims often involve extensive documentation, including hundreds of pages of medical records and legal documents, sometimes spanning months or even years.
CLARA Optics leverages predictive AI, GenAI, and LLMs to automate medical record transcription, extract key details, and deliver actionable insights to claims management teams.
This automation eliminates the need for manual document review, with AI-generated case summaries facilitating quicker case resolution, lower workloads, and better outcomes for injured workers and their employers.
CLARA Treatment uses a nationwide database of millions of workers’ compensation claims to provide data-driven insights on medical provider performance.
CLARA Triage, using the same proprietary database, helps claims professionals quickly identify high-risk claims and flag them for proactive management.
These tools offer decision support and guidance for setting reserves, leading to more accurate estimations. Injured workers receive the appropriate level of care based on injury severity, allowing Eastern Alliance’s claims professionals to focus on the most important cases.
