AI TPA is a next-generation, AI-powered Third-Party Administrator platform designed to transform the way insurance claims are handled. By combining machine learning, natural language processing, and smart automation, AI TPA significantly reduces manual tasks, accelerates resolution time, and increases accuracy — delivering a seamless experience for insurers, brokers, and policyholders alike.
Automatically extracts and structures data from emails, PDFs, images, and Excel files– Classifies and registers claims based on pre-set rules
Instantly compares claims against policy terms and coverage– Flags missing or inconsistent data for review
AI models evaluate damages and assess claim validity– Suggests payouts, rejections, or requests for additional information
AI-powered chatbots and voice assistants provide 24/7 updates, support, and claim status notifications
Real-time fraud analytics detect anomalies, duplicate patterns, and suspicious activity
Interactive dashboards with SLA tracking, operational KPIs, and loss ratio analysis
Accept claims via web portal, email, mobile app, WhatsApp, API, or file upload.
Combines Optical Character Recognition (OCR), NLP, and ML to extract and process claim information.
Applies policy-specific logic and continuously learns from past decisions to improve accuracy.
Enables manual review for edge cases or flagged decisions before final approval.
Seamlessly connects with insurance core systems, medical provider networks, pricing databases, and external registries.
- Reduce operational costs by over 40% Faster, smoother claim submissions and updates
- Improve SLA performance and consistency 24/7 support through conversational AI
- Minimize human errors and processing time
- Transparent claim status tracking and notifications
- Real-time dashboards and audit-ready reports
- Simplified experience with less paperwork
- Enhanced fraud protection at scale
- Trust-building through reliable, AI-based decision-making
Cloud-hosted and ready to use. Fast setup and scalable pricing.
Integrate modules directly into your existing workflows or core system.
Deploy a fully branded version for your brokerage or regional office.
Let us show you how AI TPA can reduce costs, increase speed, and improve client experience across your insurance operations.
📩 Contact us to schedule a demo or receive a tailored proposal.
Our company highly appreciates and values the trust that our clients place in us
The Claims functionality provides end-to-end support to insurers’ claims department needs, allowing claim teams to manage everything from claim registration and handling
Implementing [Your Company Name]'s Integration Services was a game-changer for us. We were able to connect all our disparate systems seamlessly, which significantly improved our operational efficiency and data accuracy.
John D., IT Director at XYZ Insurance
Implementing [Your Company Name]'s Integration Services was a game-changer for us. We were able to connect all our disparate systems seamlessly, which significantly improved our operational efficiency and data accuracy.
John D., IT Director at XYZ Insurance
Implementing [Your Company Name]'s Integration Services was a game-changer for us. We were able to connect all our disparate systems seamlessly, which significantly improved our operational efficiency and data accuracy.
John D., IT Director at XYZ Insurance
Implementing [Your Company Name]'s Integration Services was a game-changer for us. We were able to connect all our disparate systems seamlessly, which significantly improved our operational efficiency and data accuracy.
John D., IT Director at XYZ Insurance
