Five Sigma was founded in 2017 to leverage insurance data with deep tech. Oded Barak, Co-founder and CEO, and his partners in Five Sigma brought in domain experts in claims and tech and worked to put together a cloud solution that transformed the claims management market. Now, they’ve released another such product.
Prior to co-founding Five Sigma, Barak was the CFO at an energy business. Part of his role was overseeing insurance coverage of the group.
“We began by examining how to improve the entire claim management workflow. The innovations so far have mostly focused on digitizing the process, but it remained clunky, manual, and far from future-proof. Claim adjusters, or handlers, are essentially the quarterbacks of the process, managing it from start to finish. Our focus has been on equipping adjusters with the right tools so they can focus on their core responsibilities, while our platform handles more than just administrative tasks. By automating numerous tasks and providing enhanced visibility and analytics for leadership, we streamline the entire claims process.”
The role of Clive The insurance market is currently buzzing with AI, and Five Sigma is among the first to deliver actual solutions.
“We developed years ago an AI-native and cloud-native claims management software,” said Michael Krikheli, co-founder and CTO of the company. “Currently, we’re also using stateof-the-art Generative AI technologies to create our new AI agent.”
Barak added, “AI follows a similar path to cloud technology, decade ago. When we launched, insurers told us that they’d never get on the cloud. The industry feared anything that was not on-premise for core solutions. We knew that would change. Today, everyone is running to the cloud and talking about SaaS solutions. The same goes with AI – some might say they won’t use it, but sooner rather than later – they must.”
Earlier this year, Five Sigma unveiled Clive, the industry’s first AI insurance claims adjuster. With the uptake of AI-powered solutions, the company’s management feels they have a winner.
Clive acts as an AI adjuster that advances the claim from start to finish, helping human adjusters in most cases, and provides claim analysis and actionable insights on the go. Krikheli explained that they created an experience that takes a ‘sea of data’ that represents a claim and makes it accessible in an easy way to adjusters, and create automations, workflows, and insights on top.
The design of Clive enables the platform to work with any existing claims management system. The Five Sigma CMS is not a requirement and insurers can use Clive with their existing systems and enjoy AI capabilities immediately.
“Everything that comprises a claim can be integrated or uploaded as fully unstructured data, and Clive will work out what is going on and what are the best actions to take,” said Krikheli.
“We built an API layer to connect all relevant systems to Clive. Insurers can leverage Clive’s insights on a separate user interface, or via APIs, back in their claims management system,” he added.
Solving for insurers’ pain points
Five Sigma solve important problems for its clients across a vast multitude of markets and lines of business. The main pain points the company noticed and solves for across markets are high leakage and adjusters’ user experience.
High leakage is usually due to inefficiencies in the claims management process and human errors due to manual work, data entry, and decision making in the lack of full claim visibility.
Five Sigma also improves customer experience and blockage. Barak explained, “Blockage comes from the ability for adjusters to act when they don’t have the right data at the right time to be able to understand the claim. With Five Sigma’s CMS, the entire process is optimised and adjusters get a 360 degree to all relevant claim data, along with recommendations for next steps and resolution. Clive gives a subset of these capabilities, along with completely new ones, on top of other systems.”
Five Sigma’s Unique Value Proposition How does Five Sigma define itself apart from its competitors in an increasingly saturated market?
According to Barak, the baseline is that Five Sigma has a solid combination of both claim and technology domain expertise.
“We don’t ask our customers to think about the technology – that is our role. We give them the tech solutions they need and they are able to articulate and configure it with no code so that it is helpful for them and solves the problems they are tackling.”
“We’ve created a solid and fantastic user experience since we understand the adjuster, we understand claims leadership and what they need, and we provide them with the right tools.”
Another area of differentiation for Five Sigma is its robust AI capabilities beyond buzzwords.
The company’s CMS was developed as an AI-native cloud platform years ago and they keep advancing the capabilities with every new AI technological development that comes around.
“With our AI focus and Automation First approach, we automate every task and process that can be automated, leaving the adjusters to merely supervise the machine and do what we humans are still better at – complex decision making and customer service,” said Krikheli.
Krikheli also emphasised Five Sigma’s CMS communication tool, which centralises all claimant and stakeholder communications from all channels – email, text, phone, video – in a single platform, with AI summaries and analysis.
“We always aim to help adjusters with making good decisions and give them the tools to help their customers. We give organisations visibility to know what is going on and how they can improve. This has been our mission since the start,” he said.
AI Claims Management
The powerful role of AI is being highly emphasised in the financial sector, particularly since the onset of GenAI.
In the area of insurance, can AI drive forward claims management?
According to Krikheli, there are huge opportunities for AI in claims. “What is happening now with AI is the ability to understand natural language in ways that have never been possible.” he said. “Claim data can now be analysed through code and connected to a range of workflows that were previously really hard. With AI, we can really push forward and change the industry.”
Krikheli added Five Sigma is marrying AI technology with deep claims business knowledge. “If you take ChatGPT or Claude and ask it to handle claims, it won’t give you a specific, regulated, and compliant answer for your organisation. It would not understand your insurance company’s procedures (SOP) and would not know what works well and what doesn’t. So you need to understand the insurance business and claims mechanics, and connect them to adjusters in a simple, friendly way – this is where Clive comes in.”
The future
In the view of Barak, the company’s leadership in AI and automation sets it in good stead. “We’re early in the market, but I think AI is catching up quickly in insurance. So, I believe we are absolutely going to lead the AI claims domain.”
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