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Insurance & TPA Claims Modernization

Claims Operations Modernization
Without Rip-and-Replace

StraViso helps insurers and TPAs connect fragmented claims systems, automate repetitive work, and accelerate claim resolution — without replacing core claims, policy, CRM, document, or payment platforms.

$80B+
Annual Fraud Costs

Costs the U.S. insurance industry annually — the single largest operational loss category.

50x
Catastrophe Claim Surge

Events can spike claim volumes 10–50x, overwhelming manual processes and creating regulatory exposure.

40%
Status Inquiry Calls

Of inbound claim calls are status inquiries — a cost center that automation can eliminate.

60%
Customers Cite Slow Claims

Of customers cite slow claim handling as their primary reason to switch carriers.

Insurance carriers don't lack systems.
They lack an operating layer that connects work between them.

Claims teams are forced to move between claims platforms, policy systems, CRM, documents, payments, portals, spreadsheets, and service queues — often manually, often repeatedly, without visibility into where work is stuck.

The result is slower resolution, duplicated effort, avoidable status calls, rising operating costs, and a policyholder experience that falls short of expectation.

The answer isn't a new core system. It's an orchestration layer that connects and coordinates what you already have.

Fragmented Systems

Claims, policy, CRM, documents, and payments operate in separate silos with no shared operational view.

Manual Hand-Offs

Adjusters spend hours on status updates, queue movement, and follow-ups that should be fully automated.

No Operational Visibility

Leaders cannot see backlog, SLA risk, or bottlenecks in real time — decisions are delayed or reactive.

Slow Resolution Cycles

Avoidable delays in routing, assignment, and communication extend cycle times and increase inbound inquiry volume.

A claims operations control tower across your existing ecosystem — not a replacement for it.

StraViso creates a connected orchestration layer over the systems you already operate. Operations Cloud, Integration Gateway, Digital Workers, Decision Engine, and Reporting & Analytics coordinate work across your ecosystem — automating routine tasks, routing claims intelligently, and giving leaders a real-time view of performance, backlog, SLA risk, and customer communication.

No rip-and-replace. No multi-year migration. No disruption to existing platforms. Just faster, smarter claims operations — beginning within weeks.

Weeks, not years to first automation
Zero core system replacements required
End-to-end orchestration across the claims lifecycle
StraViso Orchestration Layer
Operations Cloud
Integration Gateway
Digital Workers
Decision Engine
Reporting & Analytics
Claims Platform Policy System CRM Documents Payments Field Ops Customer Service

One orchestrated path from first notice to final payment.

Every claim moves through the same lifecycle — but in most operations each stage lives in a different system, with manual hand-offs in between. StraViso orchestrates all nine stages as one connected flow, so work never stalls between platforms and leaders see the whole journey in real time.

1

FNOL First Notice of Loss

Claims are submitted through portals, mobile apps, call centers, agents, or email. StraViso consolidates every intake channel into a single operational workflow, verifies claimant identity up front with StraViso Verify, and initiates processing immediately — starting the clock on regulated first-contact deadlines, not the backlog.

2

Document Collection & Validation

Photos, estimates, invoices, police reports, supporting documents, and evidence are collected and validated automatically. Guided, standardized capture and early completeness checks identify missing information up front, and Proof-of-Work secures tamper-resistant, time-stamped field evidence with full chain-of-custody — reducing repeat inspections and strengthening defensibility.

3

Fraud & Risk Identification

Claims are scored against business rules, claim history, identity verification, and fraud indicators before they enter the workflow. Suspicious or mismatched submissions are flagged instantly and routed to SIU, while low-risk claims continue uninterrupted — stopping fraudulent claims earlier, not after payout.

4

Intelligent Claim Routing

Claims are prioritized and routed by complexity, urgency, geography, workload, catastrophe impact, SLA requirements, and business rules — so the worst and most time-critical claims surface first.

5

Adjuster Assignment & Field Coordination

The right claim reaches the right adjuster or field resource. Inspections, field visits, contractors, and supporting teams are coordinated through Field Cloud and Dynamic Dispatch — with optimized routing and guided capture that help every adjuster perform to a consistent standard. During catastrophes, adjusters keep capturing claims, photos, and documentation offline, syncing automatically once connectivity returns.

6

Claim Processing & Investigation

Reviews, approvals, inspections, documentation requests, and investigations are coordinated across claims, policy, CRM, document, and customer-service systems — with structured field data flowing cleanly into estimating standards such as Xactimate and Symbility.

7

Proactive Customer Communication

Automated updates keep policyholders informed across the lifecycle — status notifications, document requests, inspection updates, and settlement communications — without anyone needing to call for an update.

8

Litigation & Escalation Management

Claims requiring legal review, disputes, subrogation, or special handling are escalated automatically. Trigger documents and statutory response clocks are surfaced early — with full workflow visibility and audit history — to keep claims out of avoidable litigation.

9

Settlement & Payment

Claim decisions are finalized, approvals completed, and payment workflows initiated through existing systems — while maintaining a complete operational record.

Across All Nine Stages

Reporting, Audit & Compliance

Operational performance, SLA adherence, catastrophe response, fraud investigations, litigation activity, claim status, and compliance requirements are tracked through one centralized operational view across all nine stages. Every AI-assisted decision is human-reviewed and logged.

Closing the Loop

Back to Underwriting

The same orchestration layer feeds clean, structured claims and field data — roof age and condition, loss causes, geography — back into the risk view, so what claims already know sharpens pricing and risk selection on the front end.

Five capabilities. One connected claims operation.

StraViso deploys over your existing technology stack. Each capability builds on the last, creating an end-to-end orchestration layer without replacing a single core system.

01

Connect Existing Systems

Integrate claims, policy, CRM, documents, payments, field operations, and customer service through StraViso's Integration Gateway — without replacing any platform.

02

Orchestrate the Workflow

Coordinate intake, validation, routing, assignment, processing, communication, and settlement across teams and systems in a single operational flow.

03

Automate Repetitive Work

Deploy Digital Workers to handle document checks, status updates, queue movement, follow-ups, and exception handling — at scale, without adjuster intervention.

04

Prioritize Intelligently

Route claims by urgency, complexity, SLA risk, adjuster capacity, geography, and fraud indicators using StraViso's Decision Engine — so the right claim reaches the right resource, every time.

05

Measure and Govern

Track decisions, hand-offs, backlog, compliance, and adjuster performance in one operational view — giving leadership the real-time insight they need without rip-and-replace reporting migrations.

measure govern

What claims leaders see — without replacing existing systems.

StraViso delivers measurable operational improvement across the claims lifecycle from day one of deployment.

Faster Claim Resolution

Automated routing and orchestration eliminate the manual hand-offs and queue delays that inflate cycle times.

Higher Adjuster Productivity

Digital Workers and AI-assisted drafting handle repetitive tasks and paperwork — saving meaningful time per claim across hundreds of claims, so adjusters focus on judgment, not administration.

First-Time-Right Inspections

Guided, standardized field capture with completeness checks reduces repeat site visits — cutting the cost and the policyholder frustration of a second dispatch.

Reduced Fraud Losses

Identity verification and fraud scoring at the point of submission stop suspicious claims before they enter the workflow — attacking the industry's single largest operational loss category at intake, not after payout.

Reduced Litigation Exposure

Early identification of trigger documents and statutory response deadlines helps teams respond in time, while tamper-resistant evidence capture strengthens defensibility — keeping avoidable claims out of court, where carriers lose the most.

Fewer Status Inquiry Calls

Proactive policyholder communication, triggered automatically at every milestone, reduces inbound inquiry volume significantly.

Lower Operating Costs

Automation of high-volume, routine tasks across the lifecycle reduces manual labor cost without headcount disruption.

Resilient Surge & CAT Response

The orchestration layer scales intake, triage, and routing during catastrophe events — coordinating field operations, mutual aid, and internal capacity, with offline field capture that keeps claims moving even when connectivity is down.

Sharper Risk Selection

Clean claims and field data — roof condition, loss causes, geography — flow back into the underwriting view, helping carriers price and place risk on what their own claims already reveal.

Audit-Ready, Governed AI

Every decision, hand-off, and action is logged in a traceable operational record, and AI-assisted steps stay human-in-the-loop — supporting regulatory compliance, carrier reporting, and emerging AI-governance expectations.

Built for every claims operation. Deployable without replacing what you have.

Regional & Mutual Carriers

Rapid deployment and cost-effective automation for carriers ready to modernize operations in weeks — without rip-and-replace core system investment.

Third-Party Administrators

Productivity gains, SLA visibility, and carrier reporting transparency for TPAs managing high claim volumes across multiple programs and clients.

Specialty & Commercial Carriers

Complex workflow orchestration, documentation management, field coordination, and audit-ready compliance for specialty and commercial lines.

Large National Carriers

Enterprise-scale orchestration across high-volume, multi-system environments — connecting existing platforms without disrupting ongoing operations.

See claims operations modernization in action — without replacing a single system.

  • Walk through a live claims workflow automation scenario
  • See how StraViso integrates with your existing claims and policy systems
  • Get a tailored assessment of your claims operations improvement opportunity
  • Learn how fast you can realistically go live

No commitment required. Discovery calls and workflow assessments are complimentary.

Request a Demo
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