The problem
Every claim is handled. Few are understood.
Handlers process claims one at a time, under time pressure, from whatever documents arrive. Leakage hides in inconsistent settlement, provider costs drift without anyone benchmarking them, and the patterns that would change how you manage the book never surface, because no one is looking across all of it at once.
Volume is the enemy of pattern. A handler settling thirty claims a day will never notice that one clinic bills far above its peers for the same treatment, or that two teams settle identical losses differently — those facts only exist at portfolio level. Yet almost every control an insurer runs, from authority limits to spot audits, operates claim by claim.
What we deliver
Insight at the claim, and across the book.
How it works
Inside the workflow, not beside it.
Ingest structured & unstructured
Claims fields and documents are read together, so nothing that matters is left on the page.
Triage at intake
Each claim is scored for severity and routed before a handler opens it.
Surface the patterns
Leakage, provider and cost-driver views run across the whole book, not one claim at a time.
Deliver into your tools
Outputs land in the systems your team already uses, so insight reaches the decision.
Under the hood
The patterns we look for across the book.
Each analysis runs across every claim at once — structured fields and documents together — and each finding arrives quantified, so you know what it is worth before you act on it.
Settlement consistency. Identical losses settled differently across handlers, teams and time.
Provider cost benchmarks. Every clinic and facilitator ranked against peers for the same treatment and geography.
Cost-driver decomposition. What is actually moving average claim cost: price, utilisation, mix or severity.
Cycle-time drivers. Where claims stall, and what each delay costs in settlement value and claimant experience.
Document–field mismatch. Where the invoice and the structured claim record quietly disagree.
Recovery opportunities. Salvage, subrogation and coordination-of-benefits cases that slipped through settlement.
Repeat-claimant patterns. Claim frequency across policies and years that single-claim reviews cannot see.
Triage accuracy. Whether early routing decisions match how claims actually went on to develop.
What changes
Faster where it is simple, careful where it counts.
Straightforward claims move quickly and cleanly. Complex and high-severity claims reach the right specialist with the context already assembled. And for the first time, you can see the cost drivers across your whole book, and act on them.
The most expensive claims decisions are the consistent ones made slightly wrong — thirty times a day, for years.
THE TSP VIEWQuestions
What insurers ask us first.
Yes. Outputs are designed to land in the systems your team already uses, whether that is a triage flag at intake or a benchmarking view for a claims lead. We work with your data and workflow rather than replacing them.
Yes. Machine learning reads invoices, medical reports and correspondence so their content feeds the same analysis as your structured claims fields, with human review kept in the loop.
By comparing settlements across the whole book rather than judging each claim alone. Inconsistent payments, provider cost drift and process gaps become visible as patterns, with the drivers attached.
No. Smaller portfolios often benefit most from provider benchmarking and triage, because they lack the volume to spot patterns manually. We scope the work to the size and priorities of your book.
Whatever your team works in — a flag and a reason code at intake, a queue in your claims platform, or a benchmark pack for the claims lead’s monthly provider review. We fit the output to the decision, not the other way round.
Structured fields alone already support leakage and consistency analysis. Documents deepen it: invoices and reports let us verify what was billed against what was recorded. We start with what you have and are clear about what each layer adds.