Does the AI make claim decisions?

No. Spark Claim organizes, summarizes, scores and suggests. Your adjusters and claims managers make every decision. Business rules are kept separate from AI suggestions, and every suggestion, edit and approval is recorded.

How long does implementation take?

It depends on your workflows, your channels and the systems we connect to, so timing is set during scoping. Every engagement follows the same path: Diagnose, Configure, Integrate, Validate, Launch and measure. You can start with one intake workflow, such as Workers’ Comp FROI, and expand from there.

ClaimsSpark Claim

Turn first notice into a confident next move.

Spark Claim captures, validates, organizes, scores and routes first notices before they reach your claims system. Your adjusters get a prepared file. Your claims professionals make the call.

See it in a demo Workers' Comp FROI

Spark Claim claims queue with status, priority and assignment (demo data, details blurred)

Intake is where claims work starts to slip.

01 Incomplete, inconsistent first notices Reports arrive missing details or contradicting each other. Adjusters spend their first touch chasing information instead of working the claim.

02 Triage done by hand Scoring and prioritizing new claims is manual. Urgent files can sit in the same queue as routine ones.

03 Sorting after the fact Unfiltered intake lands in the claims system, and teams sort it out there. That means repeated data entry and unclear handoffs between intake, triage and adjusting.

What Spark Claim does

Prepare intake before it reaches your claims system.

Intake from the channels you useCapture first notices from the channels your claimants, employers and agents already use and bring them into one consistent intake flow.

Validation up frontFlag missing or inconsistent data at intake, so gaps are caught before the claim moves on.

EnrichmentAdd context from policy and external sources, so reviewers see more than what the reporter typed in.

Scoring and prioritizationScore and prioritize each new claim, so the files that need attention first get it first.

Routing to the right teamSend prepared information to the right team or claims system, based on rules you configure.

Claim summaries for reviewersGive reviewers a clear summary of each claim, so they start from an organized file instead of a stack of documents.

Part of Spark Claim

Workers' Comp first report of injury, prepared for review.

Prepare injury reports for claims review. Route the right information to the right professionals.

The Workers' Comp FROI accelerator is built for carriers, TPAs and self-insured claims organizations, and it's configured to the jurisdictions you handle.

See it in a demo

Jurisdiction-specific intakeConfigure first-report intake by jurisdiction, line of business and program.
Document preparationOrganize the injury report and supporting documents into a reviewable file.
Evidence comparisonCompare the injury report with supporting documents and flag discrepancies.
Claim summariesGive the reviewer a clear picture of the claim.
Exposure identificationSurface compensability, recovery, medical handling and return-to-work considerations for the professional to assess.
Prioritization and routingSend each report to the right professional.

STEP 1ReceiveTake in the first report of injury.
STEP 2PrepareOrganize the report and documents.
STEP 3CheckCompare the evidence and flag discrepancies.
STEP 4 · HUMANReviewA claims professional reviews and decides.
STEP 5DeliverSend the prepared claim to your claims system.

Inside the product

From first notice to a prepared file.

Intake, triage and review for P&C first notice of loss, plus the Workers' Comp first report of injury workflow.

Spark Claim incident report intake form — Incident intake form

Spark Claim intake triage and validation screen — Intake triage and validation

Workers' Comp first report of injury form — Workers' Comp first report of injury

Screens from a Spark demo environment. Data is illustrative and details are blurred.

How it fits your stack.

Spark Claim sits in front of and alongside your existing claims system. It doesn't replace it. Intake is captured, checked and organized in Spark Claim first. Prepared information then goes to your core through a translation layer and webhooks or APIs, so your claims system stays the system of record.

Spark Claim can serve more than one core system, division or program. Integration scope is set during scoping, based on your environment.

People and channels

Claimants, employers, agents and intake teams

Spark Claim

Capture · validate · score · summarize · route

Your core

Your claims system and existing core platforms

Your claims professionals keep decision authority.

Spark Claim prepares the file. People decide what happens next. AI suggestions are shown as suggestions, for a person to accept, change or set aside.

Human review gatesClaims move forward after a professional reviews them at the points you define.

Rules kept separate from AIDeterministic business rules run as rules. AI recommendations are shown as recommendations.

An audit trailAI suggestions, user edits and manager actions are recorded and traceable.

Questions

No. Spark Claim works in front of and alongside your current claims system. It prepares intake and sends organized information to your core through APIs, so your existing system stays in place.

See Spark Claim work on a real intake flow.

Book a 30-minute demo. Bring the claim type that gives your team the most trouble, and we'll walk it from first notice to routed file.

See it in a demo

Prefer email? Write to solutions@advancio.com.