Transforming Claims Management with CLARA Triage Risk Notes and Claim Event Indicators
In the ever-evolving world of insurance claims, professionals are under pressure to work smarter, faster, and more strategically. That’s where CLARAty.ai steps in, offering powerful tools that are reshaping how claims are handled from start to finish.
At the heart of this transformation are Risk Notes and Claim Event Indicators—two AI-powered innovations inside CLARA Triage that give claim professionals the insights they need, exactly when they need them.
With the launch of CLARA Triage Risk Notes and Claim Event Indicators, claims professionals and executives now have access to tools that optimize claims workflows, reduce friction, and elevate strategic oversight.
Risk Notes: Explainable AI That Surfaces What Matters
Risk Notes are AI-generated narrative summaries that decode the complexity of a claim. These dynamic summaries automatically update each time there is new information in the claim file, enabling claims professionals to quickly access the latest details.
Rather than relying solely on data fields or dense claim notes, Risk Notes uses explainable AI to synthesize structured and unstructured data to deliver a clear, concise, and human-readable explanation of what’s driving a claim’s risk or complexity.
For example, in the case of time limit or policy limit demands, Risk Notes can quickly highlight whether:
- A demand is within the current reserve, but no action has been taken by the adjuster
- The demand has been escalated for management review, in line with internal best practices
- The reserve has been reviewed and benchmarked against historical data to support informed decision-making
This kind of intelligence allows adjusters to understand not just what is happening, but why it’s happening—and what they should do next.
Claim Event Indicators: AI-Powered Signals That Drive Outcomes
While Risk Notes explain the why, Claim Event Indicators focus on the when, proactively monitoring claims for unique combinations of data that signal key turning points.
These indicators are designed to detect important milestones throughout the entire claim lifecycle, such as:
- Early-stage events: First Notice of Loss (FNOL), initial medical treatment, indemnity activity
- Mid-stage events: Return-to-work planning, treatment monitoring
- Late-stage events: Litigation, settlement, maximum medical improvement (MMI)
These indicators are built on sophisticated logic that automates much of the decision-making process around claim closure tactics. They scan, classify, and trigger alerts so adjusters can focus on the strategic aspects of claim resolution, without getting bogged down in manual reviews.
Real-Time, Targeted Interventions
Together, Risk Notes and Claim Event Indicators empower claims teams in several key ways:
- Proactive alerts: Deliver timely notifications when claims require action, helping prevent delays and missed opportunities.
- Automated intelligence: Reduce manual touches and administrative overhead by letting the AI handle routine assessments.
- Strategic focus: Free up adjusters to spend their time where it matters most—on complex claims that need human judgment.
- Dynamic customization: Adapt to evolving business needs, with models that can be trained to recognize new patterns and risk factors.
Why It Matters
In today’s competitive insurance landscape, the ability to close claims efficiently while maintaining accuracy and compliance is more important than ever. CLARA Triage makes this possible by delivering AI-powered insights that are explainable, actionable, and trustworthy.
Instead of just flagging a claim as “high risk,” Risk Notes tell you why. Instead of waiting for something to go wrong, Claim Event Indicators tell you when to act. This dual approach helps claims organizations reduce risk, cut costs, and—most importantly—serve their policyholders better. Instead of relying on closed file reviews, these indicators continually oversee each file to identify key events, insights, opportunities, and failures to comply with best practices.
Empower Your Claims Professionals with Tools to Act
The future of claims management isn’t about replacing humans with machines—it’s about empowering people with smarter tools. With CLARA Triage Risk Notes and Claim Event Indicators, adjusters are better equipped to make informed, data-driven decisions that improve claim outcomes across the board.
Interested in learning more? Discover how CLARA is redefining intelligent claims handling—one insight at a time. Request a demo today.
