Platform
Sprout.ai injects intelligence into claims management processes.
Why Sprout.ai?
Our purpose-built AI eliminates manual work in insurance claims processing – automating what’s routine, and empowering claims handlers with smart tools to quickly resolve the rest.
Robust decision support with AI-generated, data-driven recommendations & rationale, presenting case & claims handlers with insights that raise confidence in decision-making.
Exceptional accuracy enabling decisioning based on data that staff & customers trust to be right.
Data-driven decision making ensures that customer outcomes in even the most complex cases are fair, reliable & explainable.
Proven scale & agility processing millions of cases & claims annually with unlimited capacity to scale (up & down) quickly.
Rapid implementation with seamless integrations, modular design & SaaS deployment. Deploy in as little as 3 months.
How it works
Built for insurance. Trained in insurance. Trusted by insurers.
Our platform has five modules that can be used individually to address specific challenges, or combined to span your end-to-end claims processes.
The following example shows how Sprout.ai brings complete claims lifecycle automation and intelligence to your business.
Rapidly capture & prioritize every claim. Empower teams to manage workloads more efficiently.
Our Document Processing and Coding & Enrichment modules extract, codify, and enrich data captured from unstructured documents – with exceptional speed and accuracy.
This rich, codified data fuels onward claims handling processes, including policy checking, fraud detection, and decisioning.
Instantly convert very high volumes of unstructured data with AI-OCR – from a wide variety of inbound claim documents – into clean, structured data.
This enables seamless, cost-efficient automation across the entire claims handling process.
Supplement internal records with external intelligence to build an enhanced, 360-degree view of a claim. This enables rapid, accurate validations on key claim data.
Our models enrich extracted field data with external APIs, medical databases, and web intelligence to fill gaps, cross-check accuracy, and strengthen claim insights.
Auto-adjudicate the majority of claims. Deliver actionable insights that enable claims handlers to resolve complex claims quickly, and with precision.
Our Policy Coverage Checking, Fraud Flagging, and Decisioning modules deliver fully automated, straight-through processing of claims, whenever possible.
In complex or exceptional cases requiring human intervention, these modules provide claims handlers with intelligent, actionable insights and recommendations that increase the efficiency, consistency, and accuracy of every claim.
Enable fast, accurate, and complete policy compliance checking.
Automatically interpret policy documents, extract relevant clauses, cross-reference them with enriched claim data, and validate coverage terms, exclusions, and limits.
Gain early detection of potential fraud using internal and external data sources.
Automatically generate actionable, claim-level fraud insights and risk assessments. Analyze documents for authenticity, extract key claim information, and identify anomalies and unusual patterns that could reveal bad actors at work.
Empower claims handlers with real-time, data-driven insights and recommendations – along with the rationale to explain them – via AI-assisted claim review screens.
Both staff and customers can be confident that the decision is reasoned and fair.
Sprout.ai
We handle documents in virtually any language, achieving best-in-class accuracy (even for Japanese), so we can support global insurers & multi-national operations.
Effortlessly connects to leading claims management systems, ensuring seamless integration & workflow continuity – Guidewire, Duck Creek, Majesco, Sapiens, Insurity, EIS, BriteCore, DXC & more.
All decisions are traceable, referenced and explainable to customers and regulators, providing assurance for risk, compliance & operational business leaders.
48% of policyholders don’t believe insurers have their best interests at heart. Providers who fail to invest in treating customers fairly and thoughtfully pay the price in lost revenues.
Winning new customers costs 7-9x more than keeping current policyholders happy, yet 30% of dissatisfied claimants switch, citing claims experience as a bigger reason than price.
Most popular AI in insurance use cases. Why insurers buy, not build. Our AI journey.
Does Sprout.ai have customers outside of the insurance industry?
No. Sprout.ai is a specialized solution 100% focused on the insurance sector. We cater specifically to the insurance claims processing needs of:
Does Sprout.ai work across all insurance lines of business?
Yes. Sprout.ai is a one-stop-shop solution that can be deployed within a single line of business or enterprise-wide across multiple product lines. Supported sectors include:
Does Sprout.ai replace existing insurance claims handling platforms?
No. Sprout.ai is designed to augment rather than replace your current infrastructure. It acts as a behind-the-scenes insurance intelligence and automation platform that integrates seamlessly via APIs. By extracting and leveraging data for underwriting and claims, Sprout.ai helps cut costs, improve efficiency, and protect your business while supporting your existing policy administration platforms. Learn more
What insurance claims management systems does Sprout.ai integrate with?
Sprout.ai integrates with all pre-existing claims management and policy administration systems via flexible APIs. This includes:
How is AI used in insurance claims handling?
AI eliminates manual labor by automating routine tasks and providing handlers with “smart tools” for complex cases. Sprout.ai provides actionable insights, such as:
How does Sprout.ai enrich insurance claims data?
Beyond simple extraction, Sprout.ai adds context and meaning to data. This includes automated policy coverage checks and “next best step” recommendations. This enrichment is vital for insurers looking to assess policy coverage accurately and improve the detection of Fraud, Waste, and Abuse (FWA). Learn more
What operational benefits can insurers expect from Sprout.ai?
Insurers using Sprout.ai typically see significant improvements in their Combined Operating Ratio (COR), including:
Can Sprout.ai handle increased claims volumes without compromising accuracy?
Yes. Sprout.ai’s modular, scalable architecture is designed to adapt as business volumes grow, whether by product line, geography, or operational area. The platform continuously delivers exceptional levels of accuracy and performance, even as volumes rise, maintaining the same high standards for every claim processed and decision made.
Can Sprout.ai scale to handle surge events like natural disasters?
Yes. Sprout.ai is built on a modular, SaaS-based architecture designed for rapid scaling during surge events (e.g., floods or earthquakes). It allows insurers to handle sudden peaks in volume cost-effectively without compromising accuracy, compliance, or processing speed.
How does Sprout.ai help with insurance fraud detection?
Sprout.ai uses AI and predictive analytics to identify:
Does Sprout.ai support multiple languages and global operations?
Yes. Our platform supports automated data capture and enrichment in virtually any language, including complex scripts like Japanese handwriting. This enables insurers to maintain a unified global solution with full cross-border automation.
Which types of AI does Sprout.ai use?
Sprout.ai utilizes a multi-model approach tailored to specific insurance requirements:
What are LLMs (Large Language Models) used for in insurance claims processing?
Sprout.ai deploys LLMs for complex text analysis and agentic reasoning. They are core components of our modules for:
What is Agentic AI and how is it used in insurance?
Agentic AI is an advanced artificial intelligence capable of acting autonomously to pursue specific objectives. Unlike traditional AI that follows static rules, agentic AI can proactively plan, adapt, and execute multi-step tasks – breaking down high-level goals into sub-tasks to find the optimal strategy for handling an insurance claim quickly, accurately, and fairly.
What are AI-generated ‘hallucinations’ and how are they managed?
Hallucinations occur when LLMs produce plausible-sounding but erroneous or fabricated information. Sprout.ai mitigates this risk by applying robust validation logic to all AI-generated summaries and recommendations. This validation lens ensures that manual reviews are triggered whenever necessary to maintain trust and explainability.
How does Sprout.ai ensure data security and compliance?
Sprout.ai maintains the highest security standards, including:
Learn about Data Privacy & Security at Sprout.ai.
How is Sprout.ai different from other insurance claims automation providers?
Sprout.ai is purpose-built for insurance, backed by over seven years of industry-specific AI development. Key differentiators include:
