ClaimOS - AI property claims software and digital assessment platform for insurers, brokers, and loss adjusting offices
In property claims management, the real breakthrough is no longer the introduction of increasingly complex administrative systems, but the intelligent automation of processes based on substantial professional foundations, enhancing customer experience, and alternative claims settlement provided through flexible options. The ClaimPro ClaimOS property claims software is a technological paradigm shift: a hybrid software empowered by expert claims algorithms and optional AI features, capable of processing up to 80% of residential mass claims (storm, hail, pipe burst, leakages) instantly in a "Zero-Touch" manner, in a way that is best for both the client and the insurer. We are not offering just another interface, but the missing link in efficient claims management, seamlessly turning the policyholder into a loss adjuster without them even realizing it.
Although "1-day claims settlement" is the current premium standard in the insurance market, with ClaimPro ClaimOS's AI and algorithmic technology, in reality, a complete digital damage assessment, an exact claim calculation down to the penny based on real market prices, and the generation of an expert narrative report take only a few minutes from the client's initial notification. Together with internal administrative and backoffice tasks, the entire file can be ready for payout and closed within <1 hour. The secret to this is the revolutionary hybrid claims processing logic, which eliminates costly on-site inspections and provides a professional insurance claims tool for both claims administrators and policyholders.
Proven results in an enterprise environment
Hybrid technology: Algorithmic claims expert engine and optional AI assistance
Deterministic algorithm in practice
ClaimPro's strength is rooted in the present: the "brain" of the ClaimOS claims management software is a deterministic expert algorithm based on decades of experience, strictly applying claims management principles and rules. This robust rule system ensures the seamless and automated operation of full self-service, telephone, and office (backoffice) claims settlement. Our system does not rely on rounded, arbitrary amounts, but calculates using actual market hourly rates and material prices (complex items), accounting for the most intricate line items down to the millimeter (demolition, construction, debris handling, hazardous waste, ancillary costs).
Surface calculation and instant reporting
The algorithm incorporates not only the complex logic of applying intricate items, but surface formations and homogeneous/non-homogeneous area calculations are processed exactly as a human expert would prepare them, in full compliance with the rules.
And the result exceeds all expectations: not only is an itemized claim calculation compiled from professionally justified and supported items generated for our partner and the client, but the ClaimPro ClaimOS system also completes the entire narrative reporting in seconds, with just a few clicks.
Custom rules and Catastrophe (CAT) events
Adapting to our partners' unique claims management rules, the system is capable of applying custom alternative claims settlement rules in Self-Service mode. Thanks to configurable limits, it is possible to regulate in which cases, up to what amount threshold, and with what data content the claim calculation should be generated for the Clients. With a few clicks, our system can also be adjusted to handle the most difficult Catastrophe (CAT) situations in property claims.
This technology is not just a promise: it is already proven in a live enterprise environment at a major Hungarian insurance company. Over the past months, it has generated successful, validated claim calculations in the thousands, practically demonstrating a drastic reduction in administrative burdens and costs, as well as in average claim payouts and turnaround times.
We filter out AI "hallucinations" and protect data according to GDPR rules
The technology of the future is built upon this rock-solid, algorithmic foundation: the optionally integrable Artificial Intelligence (AI) image analysis, currently in its pilot phase. We are well aware that AI on its own is prone to errors (hallucinations) when it comes to exact pricing and complex claims assessment principles. In our hybrid methodology, AI "only" acts as a visual assistant: it analyzes the uploaded photos and identifies the damages, their extent, quality, and quantity. However, the specific claim calculation is always guaranteed by our infallible expert algorithm, so technological innovation never comes at the expense of professional accuracy, and we guarantee that no personal or insurance data is ever transmitted to the language model.
Hybrid ecosystem: The perfect synergy of backoffice and online damage assessment
ClaimPro ClaimOS is not simply software, but the insurer's own "Digital Claims Office" (DIGI team). It is an ecosystem that, for a fraction of current claims handling costs, with extreme speed and extra services (Fraud, Self-Service, AI), can settle 80% of property claims while providing a premium customer experience – targeting exactly the volume that places the heaviest burden on the insurer. Furthermore, on the internal interfaces, any claims administrator or contact center agent, regardless of their preparedness and professional knowledge, can create documentation and claim calculations of the exact quality and content as those prepared by expert loss adjusters. To achieve this, we have integrated into the ClaimPro property claims software all the professional rule sets, criteria, and conditions with which the system guaranteed to rival experienced human experts.
1. Internal (Backoffice) mode: The "Swiss Army Knife" for claims administrators
For claims administrators, reviewers, and Call Center staff working from their desks, this interface provides first-class support for administrative, alternative claims settlement. During telephone claims handling, the operator records the data in consultation with the client using simple questions in 3-5 minutes, and by the end of the call, the complete, detailed calculation and full report are already available. This same professional tool is perfect for the immediate algorithmic checking (invoice auditing) of incoming, often unrealistic client invoices, or for office-based claims management. The built-in correction options – such as percentage or fixed amount adjustments – are excellently suited for handling qualitative and geolocation discrepancies in claim calculations.
2. Policyholder (Self-Service) online damage assessment
Following a stressful damage event, the client creates the damage assessment and photo documentation on their own smart device – by answering everyday, easy-to-understand, simple questions. The software in the background, without the client knowing, compiles an expert-level, technically validated report and itemized claim calculation complete with photos and measurements. Following our partners' rule sets, if the set limit is exceeded, the Client completes a validated, full damage assessment during the Self Service claims process (in a BLIND / price-free mode), meaning practically the Client performs the loss adjuster's job. Processing such claims based on validated data is as simple as possible. Our partners can integrate this in two flexible ways:
- Embedded solution (API integration): The system can operate integrated directly into the insurer's website, within the existing claims reporting process. The client can independently perform the damage assessment simultaneously with the claim report, and the results (data, PDFs, photos) land on the claims department's desk within seconds.
- Invite-only damage assessment: The most secure method providing total control. Following the report, the system sends a unique, time-limited link electronically to the client. After logging in, protected by dual authentication, the client can complete the documentation at their most convenient time, thereby relieving the staff.
Intelligent Fraud Detection and proactive protection
One of the greatest risks of accelerated claims management is insurance fraud. Running proactively in the background, our system filters abuses in multiple layers and generates intelligent Security Alert System notifications for our partner's staff in the event of suspicious activity.
- Built-in manipulation filtering and optional AI image analysis: The built-in fraud detection module inherently examines the internal structure of the files, actively searching for the digital footprints of image editing software (e.g., Photoshop). This is complemented by optional AI visual image analysis, which is capable of conducting an in-depth examination of the content's originality, instantly filtering out stock photos and downloaded internet content.
- Cross-partner duplication and address match filtering (Market novelty): The software creates a unique, unalterable digital fingerprint of the uploaded photos. By comparing these against a central, anonymized database, the system instantly recognizes if a photo has already been used in a previous claim – even at another insurer – doing all this while fully respecting GDPR regulations. Additionally, the software automatically examines the provided claim location address, checking for parallel claim reports.
- Metadata and geolocation check: The system continuously analyzes the EXIF data of the uploaded photographs. Through strict "time gate" verification, it compares the exact time the photo was taken with the time of the reported damage, cross-checks the GPS coordinates of the images, and sends an immediate alert in case of any inconsistency.
DORA compliance and Enterprise SaaS: Zero IT investment, maximum security
In the financial sector, cybersecurity is not an option, but a fundamental requirement. The ClaimPro ClaimOS software was designed and is operated based on the EU Digital Operational Resilience Act (DORA) and the strictest information security standards. As part of our "Defense in Depth" strategy, we guarantee 100% logical separation of partners' data (data isolation), and the API communication is protected by HMAC SHA-256 cryptographic signatures. The system verifies uploaded documents based on strict binary content (Magic Bytes), giving no chance for malicious, disguised executable codes to enter.
Business Continuity Planning (BCP) is ensured by the transactional, "Zero data loss" architecture: the data of completed claims are immediately forwarded to the insurer, so even in extreme cases (e.g., server downtime), there is no critical data loss (~0 min RPO). In accordance with DORA regulations, the risk of Vendor Lock-in is managed by an independent legal Software Escrow and full data portability.
With the help of the built-in CMS system, the text content best suited for each application mode can be displayed on the interfaces, complete with the necessary Compliance additions, acceptance declarations, and privacy policies.
Forget about costly internal IT implementation projects taking months. ClaimPro is a ready-to-deploy Enterprise SaaS (Software as a Service) solution that can theoretically go live within 48 hours, integrating seamlessly into existing claims management systems via standard REST API connections. Thanks to the built-in White Label CMS functionality, the interface perfectly matches the company's image: custom logo, unique colors, customizable texts, and notifications sent from the insurer's own email address guarantee that the client feels in a familiar environment from start to finish.
Flexible operating models:
- In-house (Internal) model: Integrated into the insurer's own claims reporting interface (similar to a credit card payment gateway), the company operates the Self-Service solution with its own resources, and its own staff handles telephone/video claim settlements with the system's support.
- BPO (Outsourced) model: The insurer only transfers the data via API to ClaimPro, tagging the records (recommended claims channel: phone / video / Self-Service). ClaimPro executes the process using its own resources and capacity, and the insurer receives the completed, closed files back within the deadline, along with the audit logs and the payout or review proposal.
View the generated final result
Download the realistic sample documents automatically generated by ClaimPro ClaimOS.
Unique floor plan and dimensioning application on the market
Available independently from the property claims management ecosystem is ClaimPro's online floor plan and dimensioning application. Running directly from the browser without installation, it allows the creation of professional, dimensioned floor plans and detailed dimension statements on any smart device in minutes. It is the perfect tool for on-site loss adjusting work, precise claim documentation, and executing exact surface calculations in the highest quality. Complete claim documentation, floor plans, and dimensioning in minutes.
Frequently Asked Questions about the claims management software (FAQ)
Does the ClaimPro software completely replace on-site inspections?
Yes, for approximately 80% of residential claims (in the case of mass claims), ClaimPro completely eliminates the costly and time-consuming on-site inspection. Instead of a physical visit, the system provides intelligent online damage assessment, structured digital damage assessment, and the background for backoffice-supported telephone and video damage assessment. With the help of the client's smartphone, integrated AI, and algorithmic claim calculation, the insurer instantly receives a validated, priced loss adjuster's report without an on-site inspection. Naturally, we do not claim that digital claims settlement works in every case; complex - complicated, or exceptionally high estimated claim amount reports may still require an on-site inspection.
What happens during extreme weather events (Catastrophe / storm season) when the number of claim reports increases tenfold?
ClaimPro solves one of the biggest operational challenges for insurers: the scalability of mass claims. While traditional physical loss adjuster and Call Center capacities are finite (so waiting times can increase to weeks during storm season), ClaimPro's Self-Service and automated system processes 10,000 claims exactly as fast as 10. There is no need to involve expensive, temporary workforce, claim payouts remain continuous, and the insurer's perception (PR) remains excellent even in the most critical, highly loaded periods.
What cost reductions and Return on Investment (ROI) does the implementation of the software result in?
Implementing ClaimOS brings immediate, drastic cost reductions. On the one hand, it saves 100% of the fees for physical site visits and external loss adjusters in the case of mass claims. On the other hand, the deterministic algorithm operating with real market hourly rates and material prices prevents the payout of overpriced client invoices, thus the average claim amount also decreases measurably. Minimizing the backoffice load means further administrative savings.
How does the system reduce the number of invoice-based claim settlements and incoming price quotes?
With the ClaimOS system, the earliest possible payout proposal following a claim report can be realized. This has a massive psychological and financial impact on the customer experience: the immediate, fair settlement offer drastically reduces the volume of incoming restoration price quotes, subsequent contractor invoices, and paid VAT. Knowing they will receive a quick compensation, clients less frequently choose lengthy follow-ups, thus the proportion of agreement-based claim settlements increases, which results in significant savings for the insurer.
How is "Zero-Touch" and 1-day claims settlement realized?
The ClaimPro ClaimOS software is capable of automatically processing approximately 80% of residential claims (mass claims). With the self-service module, the client answers questions compiled with appropriate logic using their own smart device, and the claims expert engine instantly, without human intervention, prepares the detailed claim calculation, the comprehensive narrative reporting, and the documentation of the claim photos, so the payout or review proposal is practically immediately available to the insurer.
How can ClaimOS be integrated with existing, legacy Core systems of insurers?
The platform was built with an API-First approach. Through the Secure API Gateway and standard JSON REST API communication, ClaimPro can be seamlessly integrated into already existing (legacy) insurer CoreWeb and claim reporting systems (e.g., BRUNO). The transactional "Zero data loss" architecture ensures that the complete claim documentation and audit log are instantly and flawlessly synchronized into the insurer's own database.
How is the management of mandatory legal and acceptance declarations ensured during Self-Service claims settlement?
The system is completely flexible: the integration of multiple, custom-editable declarations appearing based on the insurer's own legal and compliance conditions is ensured in the Self-Service claims management process. The process can only move forward with the active, digital approval of the necessary legal and acceptance declarations, guaranteeing comprehensive legal security for our partners.
How complicated is the Self-Service process for claimants?
Extremely user-friendly. The digital claim report and online damage assessment run directly from the claimant's smartphone browser without downloading an application. The system guides the client through the process with minimal education and everyday, easily understandable questions. The immediate (or short turnaround time) claims settlement guarantees outstanding Customer Experience (CX) and satisfaction after stressful damage events.
What is "Blind PDF" (Blind Mode) and how does it protect the insurer?
If the automatically calculated claim amount exceeds the limit set by the insurer, the system intelligently intervenes. The client receives a technical report without prices ("Blind") at the end of the damage assessment, while the claims department sees the full amount in the background. This avoids disputes in case of unrealistic client expectations.
How does Artificial Intelligence (AI) help in fraud detection?
The optional AI module visually analyzes the images and filters out manipulated or downloaded stock photos. In addition, the system's algorithms perform a "Cross-partner" check based on an unalterable digital fingerprint, meaning they recognize if the same photo has already been submitted at another insurer.
For what claim types and items can the software be applied?
The system covers the most frequent residential property claims: storm, hail, internal and yard pipe burst, leakage insurance events. Its deterministic algorithm calculates with complex ancillary costs (e.g., demolition, debris removal, scaffolding, plastering, hazardous waste, call-out fee) based on real market hourly rates, adhering to professional claims rules and claims settlement principles. It also knows technological differences, for example, the damages of panel or brick buildings and the correlations of the damages, based on the built-in and algorithmicized senior loss adjuster experience of several decades.
What management statistical and analytical possibilities does the system provide?
ClaimOS's detailed statistical module, filterable for custom periods, makes item counts and payout averages transparent by events, users, and claimants. In addition, a performance ranking of internal users is also available, together with the average and value of correction amounts applied during claim calculations, supporting management decision-making and operational control.
What questions does the system ask during Self Service claims settlement?
It only asks the relevant questions in a logical context that, in 80% of mass claims, immediately make the system suitable for preparing a precise claim calculation and report. Alongside the questions, we also support the claimant with built-in educational content and easily understandable informational texts. With this, we relieve the insurer, while in the background the system immediately ensures fast, simple, pinpoint-accurate damage assessment and detailed claim calculation, as well as the automated creation of comprehensive, narrative reports.
How does the system handle the shortage of loss adjusters and resource optimization?
The shortage of highly trained physical loss adjusters is an increasingly burning HR problem in the market. ClaimPro's deterministic algorithm is in fact the digitalization of decades of senior loss adjuster knowledge (know-how). By having the system and the client independently settle 80% of routine residential claims, the insurer can focus its remaining scarce human loss adjuster capacity on the truly complex, suspicious, or high-value (20%) claims, maximizing claims administrator efficiency.
Is costly internal IT development necessary to implement ClaimOS?
No, practically zero IT investment is required. ClaimPro ClaimOS is an Enterprise SaaS cloud-based solution that communicates via a standard REST API (Plug & Play). Thanks to White Label technology, the client-side interface can be tailored to the insurer's own image (colors, logo, GDPR) within up to 48 hours.
How can different areas of use be managed in the system?
An unlimited number of API clients is available for each of our partners. These clients can all be parameterized individually, so they can be perfectly separated and customized for different areas of use, subtypes, or partner needs.
How are prices and items applied during claim calculation structured?
The pricing of (even complex) items and fees applied during claim calculations can be set completely uniquely in each API client. The system adapts to the partner's unique internal pricing and norms, and can be flexibly modified at any time according to needs.
How is the traceability of claim files and the transfer of claim history ensured?
In the system, a complete audit log relating to every claim event is accessible down to the action level. It accurately records every interaction of the users (staff), clients, and the system. Upon closing the claim, this entire claim log is automatically transferred via API into the insurer's own Core system.