Adaptional

Adaptional is an insurance tool that provides custom AI for claims and underwriting. It reads, extracts, and analyzes data to help teams focus on decisions, not manual data processing.

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At a glance

Pricing

Likely Not Free

Free tier

API

Skill level

Technical

About

What is Adaptional?

Adaptional offers custom AI solutions specifically designed for the insurance industry, focusing on claims and underwriting processes. The platform reads, extracts, and analyzes data from various sources, including claims systems like Guidewire and Duck Creek, to automate and enhance decision-making. It provides continuous claims review, auditing 100% of claims to identify compliance gaps, leakage, and reserve issues in real-time. Adaptional allows users to configure audit guidelines based on compliance, coverage, reserves, leakage, service quality, and subrogation, surfacing issues as they happen. This eliminates the need for manual QA, which often samples only a small percentage of claims and identifies problems too late.

Best used for

Ideal for insurance carriers and MGAs who need to automate claims auditing, identify compliance risks, and reduce financial leakage. Especially valuable for ensuring every claim is reviewed against defined criteria in real-time, rather than relying on manual sampling.

Common actions

automate claims processing

improve underwriting accuracy

detect insurance leakage

ensure compliance

analyze insurance data

Capabilities

Key features

AI claims review
Audit 100% claims
Real-time issue surfacing
Configurable audit guidelines
Claims data integration
Leakage identification
Reserve issue flagging

Target Audience

insurance claims managersinsurance underwritersinsurance compliance officersinsurance fraud investigators

Integrations

guidewireduck-creek

Pricing & Plans

Likely Not Free

Not publicly disclosed. Check adaptional.com for current pricing.

FAQs

How does Adaptional integrate with existing claims systems?

Adaptional can ingest data from various claims systems, including Guidewire and Duck Creek, as well as other sources like files, notes, and documents. It's designed to be up and running quickly without requiring extensive integration projects.

What types of issues can Adaptional identify in claims?

Adaptional evaluates claims across six dimensions: compliance, coverage, leakage, service quality, subrogation, and reserves. It flags issues like missed deadlines, regulatory violations, coverage errors, overpayments, missed deductibles, and stale reserves.

How does Adaptional improve upon traditional manual QA processes?

Unlike manual QA which samples a small percentage of claims, Adaptional audits 100% of claims continuously and in real-time. This allows for immediate identification and resolution of issues, preventing leakage and compliance problems before they escalate.

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Data & Analytics › Data Cleaning & Prep AI Agents & Automation › RAG & Document AI Productivity & Business › Workflow Automation

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