Insurance Claims Automation

Action the Halo Effect to support straight-through processing


Discover autonomous claim payment and fraud avoidance

Daisy’s AI-powered Claims Automation Solution supports straight-through processing via autonomous claim payment and fraud avoidance decisions, including auto-pay; auto-deny; investigation for potential fraud, waste or abuse; accelerated human review; and full manual adjudication. 

Your own business rules, eligibility criteria, complexity/materiality thresholds and robotic process automation (RPA) can apply.

We’re offering


A Claims Automation Solution that makes an impact

Male and female insurer collaborating and looking at tablet
With our Claims Automation Solution, insurers will:

Significantly increase straight-through processing rates 


Have the potential to increase rates by >500% 


Deliver customer excellence by serving genuine customers with greater speed

Male insurer presenting on company finances
Our solution reduces:

Operational costs


The need for manual labor and the associated costs


The risk of fraud and its financial impacts

Male insurer meeting with male and female clients
Our Claims Automation Solution enables: 

Faster claims processing and better accuracy


Increased positive customer experiences


Improved overall customer loyalty and retention

Male and female insurers collaborating in office using laptop
Our solution delivers:

Comprehensive rationales for why a claim is or isn’t suspicious


Opportunities for tiered human review to ensure the system is functioning as expected


Trust in the system’s operational capabilities in effect



Mitigate emerging fraud and risk with Halo-based AI

Identify risk and avoid fraud with the Halo Effect whitepaper

The features that make us unique

Insurance AI Solutions

Tiered human review

Our solution reduces the risk of manual processing errors with highly precise adjudication recommendations. However, we know that sometimes human review is required. As such, we provide opportunities for tiered human review - ensuring efficient use of your team’s time, that the system is always functioning as expected, and that trust is built with system users.
Insurance AI Solutions

Cutting-edge AI

Our technology applies reinforcement learning, fuzzy logic, and a proprietary mathematical theory (Theory of Risk™) to resolve identities, detect suspicious claims and avoid costly fraudulent payments, all while automating claims processing. When complex cases require human intervention, investigators receive contextual guidance from Daisy that supports decision-making.
Insurance AI Solutions

Automated straight-through processing decisions

Our Claims Automation Solution actions the Halo Effect to provide highly precise adjudication recommendations and actions to automate claims processing. From intake to settlement, Daisy reduces the need for manual intervention and speeds up the overall claims review process.
Insurance AI Solutions

AI made simple

Our patented software runs autonomously, preventing human error in claims processing. Daisy takes the complexity out of artificial intelligence; we provide plain-language explanations for all our alerts.

Learn more about our tech

Interested in our Claims Automation Solution?

Get in touch to see how Daisy is transforming claims management



+1 905-642-2629

Learn more about how we identify the Halo Effect – outliers in high-volume claims data – to avoid fraud and support the straight-through processing of genuine claims.


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