Insurance

Claims Processing Automation

Intelligent claims assessment, document verification, and fraud detection that processes claims 10x faster with 85% automation

90%

Faster Processing

85%

Automation Rate

95%

Fraud Detection

The Challenge

Insurance claims processing is labor-intensive, slow, and expensive. Claims adjusters manually review documents, verify coverage, assess damages, and detect fraud across multiple systems. The average claim takes 15-30 days to process, leading to poor customer satisfaction and high operational costs.

Current State Pain Points:

  • Manual Document Review: 4-6 hours per claim reviewing medical records, police reports, photos
  • Slow Processing: 15-30 days average claim resolution time
  • Fraud Losses: $80B annual fraud losses due to manual detection limitations
  • Poor Customer Experience: 45% of customers dissatisfied with claims process speed

The Helium Solution

Helium automates claims intake, document analysis, coverage verification, damage assessment, and fraud detection. AI agents process claims 10x faster with 95% accuracy in fraud detection.

90%

Faster Processing

85%

Automation Rate

95%

Fraud Detection

Automated Capabilities

Document Intelligence

Extract and analyze data from medical records, police reports, repair estimates, and photos. Verify information across documents automatically.

Coverage Verification

Instantly verify policy coverage, deductibles, limits, and exclusions against claim details. Flag coverage issues immediately.

Fraud Detection

AI models trained on historical fraud patterns detect suspicious claims with 95% accuracy. Analyze claim patterns, document inconsistencies, and behavioral signals.

Damage Assessment

Computer vision analyzes damage photos, estimates repair costs using historical data, and generates settlement recommendations automatically.

Measurable Business Outcomes

90%

Faster Processing

From 20 days to 2 days

85%

Automation Rate

Straight-through processing

$12M

Annual Savings

Per 100K claims processed

Auto Insurance Provider Case Study

Challenge: A regional auto insurer processing 100,000 claims annually had 20-day average processing time, 60% customer satisfaction, and $8M annual fraud losses. Claims adjusters were overwhelmed with document review.

Helium Implementation: Integrated with policy management system, repair shop network, and medical provider databases. AIM trained on claims guidelines, fraud patterns, and damage assessment protocols.

Results After 6 Months:

  • Processing time reduced from 20 to 2 days (90% reduction)
  • 85% of claims processed automatically without human review
  • Fraud detection improved from 60% to 95% accuracy
  • Customer satisfaction increased from 60% to 92%
  • $12M annual savings ($6M fraud prevention + $6M operational efficiency)

Technical Capabilities

Document Intelligence

OCR, handwriting recognition, and semantic understanding of medical records, police reports, and repair estimates

Computer Vision

Analyze damage photos, detect inconsistencies, and estimate repair costs with 95% accuracy

Fraud Detection

Pattern recognition, anomaly detection, and network analysis to identify fraudulent claims

Real-Time Processing

Process claims as they arrive with instant verification and decision-making

Helium vs. Traditional Claims Systems

Traditional Systems

Tools Required (8+):

  • • Claims Management System
  • • Policy Administration
  • • Fraud Detection Software
  • • Document Management
  • • Payment Processing
  • • Customer Portal
  • • Reporting Tools
  • • Manual Review Process
Processing Time
20 days
Automation Rate
15%
Cost per Claim
$180

Helium Platform

Unified Solution:

  • ✓ End-to-end automation
  • ✓ AI document processing
  • ✓ Advanced fraud detection
  • ✓ Computer vision assessment
  • ✓ Instant decisions
  • ✓ Customer self-service
Processing Time
2 days
↓ 90% reduction
Automation Rate
85%
↑ 467% increase
Cost per Claim
$45
↓ $135 savings

Transform Your Claims Processing

See how Helium delivers 90% faster processing with 85% automation

Request Demo