Elysian takes aim at insurers’ claims audit blind spots

Elysian takes aim at insurers' claims audit blind spots

Elysian, a New York-headquartered claims quality platform and AI-native TPA, has rolled out a pair of AI products aimed at helping carriers monitor the standard of claims handling across their whole book rather than a small sample.

The two offerings, Ely Audit and Ely Adjust, focus on separate stages of a claim’s life. Ely Audit scans claims files at portfolio level to surface recurring risks and trends, whereas Ely Adjust keeps watch over live claims and suggests actions at a point when the result is still open to change.

Elysian is positioning the launch against the shortcomings of standard audit programmes, which generally examine roughly 2% of a carrier’s files. According to the company, that approach leaves much of an insurer’s book unexamined, making it difficult to judge whether claims are being handled well and consistently.

Ely Audit replaces periodic sampling with a review of every claim in a portfolio, both closed and still active. It plugs into a carrier’s current claims systems and is capable of working through long-tail files that run to thousands of documents. Its assessments cover handling standards, adherence to agreed procedures and how outside vendors are performing. Instead of issuing a simple pass or fail grade, the tool produces in-depth findings on risks, patterns and opportunities, which Elysian said can help carriers catch poor handling habits early and stop them spreading to further files.

Ely Adjust brings this analysis into the handling of active claims. Each open file is checked every day, with the system highlighting changes that may need a response and advising handlers on what to consider next. Decision-making stays with the adjuster, as the tool offers recommendations rather than settling outcomes itself. It also supplies explainable reasoning and an optional layer of supervisor sign-off.

The company said both tools draw on its expertise in admitted, non-admitted, personal and commercial lines. Carriers can buy either product on its own, as a bundle, or alongside Elysian’s TPA services.

Elysian pairs AI software with hands-on TPA support for complex, high-value claims, spanning real-time claim review, automated auditing, continuous file monitoring and expert oversight. Grace Hanson, a five-time chief claims officer, launched the business in 2024. Members of its founding team have led claims at firms such as Allied World, Hippo and Hiscox, collectively managing reserves worth hundreds of billions of dollars, while its technical staff includes engineers and researchers from technology and FinTech companies.

Elysian is among five finalists in Guidewire’s InsurPitch Competition at ITC Vegas. Hanson will also speak on a CB Insights panel about the Top 50 InsurTech Report, and the company will be exhibiting at booth #2505 in the Expo Hall.

Elysian founder and CEO Grace Hanson said, “Throughout my career, managing claims quality at scale has been a persistent challenge. Quality depends on several factors including customer experience, coverage accuracy, fraud mitigation, and the processes each claim requires. The insurance industry must move beyond dashboards that drown teams in unnecessary data and gain visibility into ‘the messy middle’ of complex claims. Ely Audit and Ely Adjust bring humans, AI, data, and partners together to improve claims quality, support stronger decisions, and mitigate risk.”

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