How AI Helps Claims Teams Focus on What Really Matters
Author: Stijn Venrooij, CCO Posthuma Partners
Every day claims teams face the same pressure: review thousands of claims, spot the exceptions and do it all faster with fewer resources. But what happens when routine claims hide high-cost anomalies? Or when experienced reviewers miss fraud patterns simply because the volume is too high?
This is where artificial intelligence is making a quiet but profound impact across the insurance sector.
A Smarter Way to Handle Claims Complexity
AI in claims management is not about replacing claim experts it is about giving them sharper tools to make better decisions faster. Instead of manually checking each claim one by one claims teams can now rely on intelligent filters that highlight unusual patterns, pricing inconsistencies or mismatches with policy coverage.
This lets experts’ step in exactly where they are needed most. Time is no longer wasted on low-risk predictable cases and more focus is given to the claims that carry financial or reputational impact.
From Manual Review to Meaningful Oversight
At Posthuma Partners we have developed the Claims Management Filter (CMF®) to support this shift. CMF® is a proven technology and works for over 10 years in more than 15 different countries, it reviews entire claims portfolios using AI and actuarial models to:
- Detect outliers in medical repair or parts related costs
- Surface inconsistencies between policy coverage and claimed services
- Flag repeat anomalies across garages hospitals or provider networks
- Accelerate straightforward claims that meet policy and pricing rules
The result is a much more efficient and consistent review process where nothing is overlooked and the data does the heavy lifting.
Why This Works So Well with Axon
Our collaboration with Axon means CMF® is embedded into a digital claims journey from start to finish. While Axon provides the modern infrastructure to handle claims data and workflow Posthuma Partners adds intelligent control and insight on top of it. The combination allows insurers to act on insights in real time and stay ahead of financial risk.
It is a partnership that brings technology and decision intelligence together to serve one goal: better control over claims outcomes.
It Is Not About More Tech It Is About Better Control
In a recent claims review CMF® helped one insurer identify over 25 percent of payouts needing follow up many of which came from trusted providers or routine diagnostics. These are the kinds of issues that easily go unnoticed without structured data oversight.
By bringing AI into the core of claims handling insurers can finally move from reactive review to proactive control.
Learn more about CMF® and how Posthuma Partners and Axon are working together to help insurers regain control