CLARA Analytics Introduces Triage Risk Notes and Claim Event Indicators to Advance Claims Management

CLARA Analytics Triage Risk Notes have been launched alongside new Claim Event Indicators, adding advanced AI features to the claims management process. These tools help insurance companies find high-risk claims sooner and use their resources more wisely. CLARA wants to improve claim outcomes and operational efficiency by using predictive analytics for insurers.

With claims organizations under mounting pressure to utilize data and analytics to optimize performance and productivity, Risk Notes and Claim Event Indicators deliver oversight that addresses critical operational pain points around missed opportunities that every claims organization faces. Instead of waiting for periodic file reviews on a small sample size to identify issues after claims close, these AI-powered tools continuously assess every claim in the organization’s portfolio throughout its entire life cycle.

“The insurance industry has relied on retrospective sample file reviews for far too long,” said Heather H. Wilson, CEO of CLARA Analytics. “We’re applying AI strategically to lead the industry forward. By taking a more proactive approach, powered by intelligence, every single claim can be handled more efficiently than ever before, with unparalleled accuracy and precision. This saves time, money and frustration.”

The new Claim Event Indicators further enhance AI in claims management, helping insurers make proactive decisions and reduce losses.

The new tools are designed as part of CLARA Triage, which helps teams prioritize specific claims and prompts them to take recommended actions. Using AI, CLARA Triage makes it easy for adjusters to manage the claims that need attention while streamlining others that likely won’t require additional intervention.

Risk Notes: Explainable AI That Surfaces What Matters Most 

Risk Notes represent a breakthrough in AI explainability for claims management. These dynamic narrative summaries automatically decode claim complexity and update each time new information enters the file. Rather than forcing adjusters to parse dense claim notes or isolated data fields, Risk Notes synthesizes structured and unstructured data into clear, human-readable explanations of what’s driving a claim’s risk profile. This allows adjusters to understand not only what is happening but why it’s happening and what they need to do about it.

For example, when it comes to time limit or policy limit demands, Risk Notes immediately highlights critical gaps, and it can escalate the cases for management review. The system also provides reserve benchmarking insights driven by historical data, ensuring decisions are grounded in proven outcomes rather than guesswork.

Claim Event Indicators: AI-Powered Signals That Drive Better Outcomes

While Risk Notes explain the why, Claim Event Indicators focus on the when, persistently analyzing claims for sophisticated combinations of data that identify key turning points. These indicators detect critical milestones across the claim life cycle. That includes early-stage events like first notice of loss and initial medical treatment, mid-stage developments such as return-to-work planning and treatment monitoring, and late-stage events encompassing litigation, settlement, maximum medical improvement, and more.

Built on advanced logic that automates decision-making around claim closure tactics, the system scans, classifies and triggers alerts so adjusters can focus on strategic claim resolution without getting overwhelmed by manual reviews.

Transforming Claims Operations Through Intelligence

The combination of Risk Notes and Claim Event Indicators addresses fundamental challenges that have plagued claims organizations for decades. Together, they empower claims teams through:

• Proactive Alerts: Delivers timely notifications when claims require action, preventing delays and missed opportunities that traditional file reviews catch too late.
• Automated Intelligence: Reduces manual oversight and administrative overhead by letting AI handle routine assessments continuously rather than periodically.
• Strategic Focus: Provides adjusters and managers with the data and insights to focus on the priority issues that require human judgment.
• Dynamic Adaptation: Evolves with changing business needs through models trained to recognize new patterns and risk factors.

These features will drive the future of claims processing as the industry becomes increasingly competitive. The ability to proactively identify and address claim issues in real time rather than through post-closure analysis represents a true advantage.

“We’re not replacing human expertise — we’re amplifying it with smarter tools that provide continuous oversight and strategic guidance. That’s what this launch is about, and we will continue to push the envelope with AI innovation for the betterment of the insurance industry,” added Wilson.

CLARA Triage Risk Notes and Claim Event Indicators are available immediately for workers’ compensation claims. Auto and general liability will be added in the coming months. Learn more at www.claraanalytics.com.

With the rollout of CLARA Analytics Triage Risk Notes, AI-driven insights give insurers smarter tools for finding risks early and settling claims faster.