ClaimFlow is an AI-powered claims management platform built for Indian health insurers and TPAs — automating intake, document verification, and fraud scoring through the SENTINEL engine.
ClaimFlow sits on top of your existing claim intake — no rebuild required — and scores every claim through SENTINEL's multi-layer engine before it reaches an adjuster.
A multi-layer scoring system combining rule-based signals, OCR cross-validation, hospital verification, and ML — every score comes with a full audit trail.
Every hospital bill is extracted, cross-checked, and reconciled against the claimed amount automatically — mismatches route straight to human review.
Clean, verified claims settle automatically — under configurable guards your admin controls, so you always decide where the line is.
Via web portal or WhatsApp — policyholder uploads bills and details.
OCR pulls amounts, hospital, diagnosis, and cross-checks against policy data.
Every layer scores the claim; a weighted composite produces a verdict.
Clean claims auto-approve; flagged claims go to an adjuster with full reasoning.
Plug SENTINEL into your existing claim intake as a fraud-intelligence layer. Handle more insurer volume without proportional adjuster hiring — you keep billing your clients as normal.
Reduce fraud leakage and settlement time without replacing your claims system. Hosted in India, built for IRDAI-regulated workflows.
Send a batch of anonymised past claims and we'll show you exactly what it catches — no commitment, 20 minutes.