Claims Assessment Engine

A risk triage and assessment automation engine to increase caseload capacity, develop staff and improve outcomes.

What you're up against Key challenges affecting assessment quality and speed

  • Loss of expertise

    Loss of expertise due to retirements​.​

  • Imbalanced caseloads

    Imbalanced caseloads and task assignments​.​

  • High-complexity claims

    High-complexity claims misassigned to junior talent​.

How it works Achieve superior decision accuracy and consistency

Our Claims Assessment Engine uses configurable rulesets to support smarter workflows. It automatically assigns cases, adjudicates low-risk claims, and provides decision recommendations and next-step guidance for complex cases.

Further Information

Configurable risk-based rules for individual & group products

When making claims decisions, claims experts can assess the nature and quality of claims evidence against a set of configurable risk-based rules.

Expertise that doesn't retire

Operations can be protected from retirement brain drain by accessing Swiss Re’s extensive global claims knowledge via industry-leading rulesets used to automate, explain and guide examiners to consistent decisions.

Fully auditable

The solution provides a consistent, repeatable, transparent and accurate assessment on every claim, every time.

What to expect Impact on your business with our Claims Assessment Engine

  • Increase capacity without adding staff

    Accelerate low-risk claims for faster payouts and free your team to focus on high-value, complex cases – maximising efficiency and impact.​

  • Develop staff and avoid talent pipeline constraints

    Step-by-step claims assessment guides examiners through complex cases, developing new and existing talent.

  • Improve outcomes and reduce risk

    Our fully auditable engine protects your bottom line from invalid claim payments, legal challenges and regulatory audits.​

Real stories, real results Settling claims faster, cutting costs, delighting customers

Swiss Re x SBLI

SBLI partners with Swiss Re to improve life and health claims experiences using our Claims Portal and Claims Assessment Engine.

Start your journey today

Ask our experts to explore how PromiseXP can help you unlock end-to-end claims automation.

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