Automate routine claims, prioritize complex cases, detect anomalies, and cut turnaround time, without sacrificing consistency or oversight.
Score every claim for routine vs. complex handling.
Auto-approve, request docs, or escalate.
Anomaly scoring routes risk to SIU.
Pull structured data from forms and PDFs.
Match each case to the best-fit team.
Give handlers a concise case brief.
Estimate exposure early for reserving.
Surface where processing stalls.
It recommends and automates the routine, but complex and high-risk claims are routed to human handlers with decision-support summaries. You keep oversight and control.
OKEMA reads from your claims platform and writes recommendations and routing back into the same queues your handlers already use.
A focused pilot on one line of business, motor or travel, for example, typically shows turnaround and workload improvements within the first cycle.
Suspicious claims are scored and prioritized for your SIU team. The system assists investigators with ranked cases; it does not auto-deny claims.
Start with a roadmap that quantifies the turnaround and cost impact on your claims book.
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