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The omni:us Digital Claims Adjuster

Automate your claims in
high-frequency lines of business

The omni:us Digital Claims Adjuster enables seamlessly integrated end-2-end P&C claims automation within existing insurance systems, such as Guidewire, Sapiens or legacy applications.  Integrated reference claims processes, as well as a comprehensive, AI-powered claims decision catalog, help drastically cut down process costs – while noticeably increasing customer satisfaction and efficiency.

  • Household / Property
  • Liability
  • Motor
supported perils
Fire
Storm / Elemental
Tap Water
Glass Breakage
Burglary / Theft
Automated Claims Actions for Property & Household
1

Identification and classification of

  • Policy
  • Claim number
  • Policyholder
  • Place, time
  • Risk, objects
  • Context, interpretation
2
  • Claimsfile creation
  • Prevent duplicate claims file creation
  • Amendment management

 

3
  • Contract active
  • Insignificance check (self-retention)

Coverage given for

  • Risk
  • Loss location
  • Object
  • Person(s)
4

Identification of

  • Damage
  • Extent of damage
  • Involved parties and their roles

Verification of basic completeness for

  • Mandatory information
  • Documents
  • Rel. data points

+

  • Consideration of other customer-specific completeness requirements
  • Trigger of necessary supplements
5
  • Clarification of relevant damage issues
  • Interpretation of the cause of damage
  • Clarification of obligations and exclusions

+

  • Consideration of contract-specific coverage rules
  • Triggering of necessary supplements
6
  • Determination of the amount of the claim and the amount of the payout
  • Allocation of payment information
  • Adjustment of reserves
  • Trigger of payout
Automated Claims Actions
for Household / Property
1

Claims indexation

Identification and classification of:

  • Policy
  • Claim number
  • Policyholder
  • Place, time
  • Risk, objects
  • Context, interpretation
2

Claims indexation

  • Claimsfile creation
  • Prevent duplicate claims file creation
  • Amendment management
3

Formal coverage check

  • Contract active
  • Insignificance check (self-retention)
  • Coverage given for
    Risk
  • Loss location
  • Object
  • Person(s)
4

Completeness check

Identification of:

  • Damage
  • Extent of damage
  • Involved parties and their roles

Verification of basic completeness for

  • Mandatory information
  • Documents
  • Rel. data points
  • Consideration of other customer-specific completeness requirements
  • Trigger of necessary supplements
5

Coverage Determination

  • Clarification of relevant damage issues
  • Interpretation of the cause of damage
  • Clarification of obligations and exclusions
  • Consideration of contract-specific coverage rules
  • Triggering of necessary supplements
6

Claim settlement

  • Determination of the amount of the claim and the amount of the payout
  • Allocation of payment information
  • Adjustment of reserves
  • Trigger of payout
Next Best Action OR STEERING TO CLAIMS ADJUSTER IS POSSIBLE AT ANY POINT
supported perils
Personal Liability
Home / Landowner
Automated Claims Actions for Liability
1

Identification and classification of

  • Policy
  • Claim number
  • Policyholder
  • Place, time
  • Risk, objects
  • Context, interpretation

+

  • Claimant
2
  • Claimsfile creation
  • Prevent duplicate claims file creation
  • Amendment management

+

  • Doubled claimsfile creation
3
  • Contract active
  • Insignificance check (self-retention)

Coverage given for

  • Risk
  • Loss location
  • Object
  • Person(s)
4

Identification of

  • Damage
  • Extent of damage
  • Involved parties and their roles

Verification of basic completeness for

  • Mandatory information
  • Documents
  • Rel. data points

+

  • Consideration of other customer-specific completeness requirements
  • Trigger of necessary supplements
5
  • Clarification of relevant damage issues
  • Interpretation of the cause of damage
  • Clarification of obligations and exclusions

+

  • Consideration of contract-specific coverage rules
  • Triggering of necessary supplements

+

  • Clarification of factual fault
6
  • Determination of the amount of the claim and the amount of the payout
  • Allocation of payment information
  • Adjustment of reserves
  • Trigger of payout
Automated Claims Actions
for Liablity
1

Claims indexation

Identification and classification of:

  • Policy
  • Claim number
  • Policyholder
  • Place, time
  • Risk, objects
  • Context, interpretation
  • Claimant
2

Claims indexation

  • Claimsfile creation
  • Prevent duplicate claims file creation
  • Amendment management
  • Doubled claimsfile creation
3

Formal coverage check

  • Contract active
  • Insignificance check (self-retention)
  • Coverage given for
    Risk
  • Loss location
  • Object
  • Person(s)
4

Completeness check

Identification of:

  • Damage
  • Extent of damage
  • Involved parties and their roles

Verification of basic completeness for

  • Mandatory information
  • Documents
  • Rel. data points
  • Consideration of other customer-specific completeness requirements
  • Trigger of necessary supplements
5

Coverage Determination

  • Clarification of relevant damage issues
  • Interpretation of the cause of damage
  • Clarification of obligations and exclusions
  • Consideration of contract-specific coverage rules
  • Triggering of necessary supplements
  • Clarification of factual fault
6

Claim settlement

  • Determination of the amount of the claim and the amount of the payout
  • Allocation of payment information
  • Adjustment of reserves
  • Trigger of payout
Next Best Action OR STEERING TO CLAIMS ADJUSTER IS POSSIBLE AT ANY POINT
supported perils
Fully Comprehensive Coverage
Partial Comprehensive Coverage
Glass Breakage
Vehicle Liability
Automated Claims Actions for Motor
1

Identification and classification of

  • Policy
  • Claim number
  • Policyholder
  • Place, time
  • Risk, objects
  • Context, interpretation

+

  • Car data
  • Damage to the vehicle

+

  • Claimant
2
  • Claimsfile creation
  • Prevent duplicate claims file creation
  • Amendment management

+

  • Doubled claimsfile creation
3
  • Contract active
  • Insignificance check (self-retention)

Coverage given for

  • Risk
  • Loss location
  • Object
  • Person(s)
4

Identification of

  • Damage
  • Extent of damage
  • Involved parties and their roles

Verification of basic completeness for

  • Mandatory information
  • Documents
  • Rel. data points

+

  • Consideration of other customer-specific completeness requirements
  • Trigger of necessary supplements
5
  • Clarification of relevant damage issues
  • Interpretation of the cause of damage
  • Clarification of obligations and exclusions

+

  • Consideration of contract-specific coverage rules
  • Triggering of necessary supplements

+

  • Clarification of factual fault
6
  • Determination of the amount of the claim and the amount of the payout
  • Allocation of payment information
  • Adjustment of reserves
  • Trigger of payout
Automated Claims Actions
for Motor
1

Claims indexation

Identification and classification of:

  • Policy
  • Claim number
  • Policyholder
  • Place, time
  • Risk, objects
  • Context, interpretation
  • Car data
  • Damage to the vehicle
  • Claimant
2

Claims indexation

  • Claimsfile creation
  • Prevent duplicate claims file creation
  • Amendment management
  • Doubled claimsfile creation
3

Formal coverage check

  • Contract active
  • Insignificance check (self-retention)
  • Coverage given for
    Risk
  • Loss location
  • Object
  • Person(s)
4

Completeness check

Identification of:

  • Damage
  • Extent of damage
  • Involved parties and their roles

Verification of basic completeness for

  • Mandatory information
  • Documents
  • Rel. data points
  • Consideration of other customer-specific completeness requirements
  • Trigger of necessary supplements
5

Coverage Determination

  • Clarification of relevant damage issues
  • Interpretation of the cause of damage
  • Clarification of obligations and exclusions
  • Consideration of contract-specific coverage rules
  • Triggering of necessary supplements
  • Clarification of factual fault
6

Claim settlement

  • Determination of the amount of the claim and the amount of the payout
  • Allocation of payment information
  • Adjustment of reserves
  • Trigger of payout
Next Best Action OR STEERING TO CLAIMS ADJUSTER IS POSSIBLE AT ANY POINT
Discover Reference Processes
Our Performance

Straight-Through Processing At Scale

%

Full Automation
Straight-through-processing

  • Focus on simple and medium-complex claims
  • End-to-end processing from FNOL to payment
  • Significant savings potential due to straight-through-processing

+

+

%

Semi-Automation
Next Best Actions & recommendations

  • Focus on medium and very complex claims
  • Significant time savings potential (up to 90%) through partial automation
  • Example processes: information requests, rejection recommendations, coverage concerns
  1. Listed KPIs are average values across different line of businesses that are calculated as a basis of value-based pricing in our collaboration with omni:us business cases.
  2. Focus on frequency claims with an average claim volume of < €3.000.

Relied on by leading insurers.

"omni:us AI settles 70% of the submitted claims end-2-end, without manual intervention."

Wolf Gerlach
Board Member Operations
UNIQA

"We already produce millions of dollars of gross written premium – new business for us, just through this technology.”

Ariel Gorelik
COO
AmTrust Financial

“There were no structured data inputs required for getting to as much as 80% automation level just by using the technology omni:us has in place.”

Andreas Nemeth
General Partner
UNIQA Ventures

“Thanks to the technology developed by omni:us, we will be able to make our core business even better throughout all country subsidiaries.”

Adrian Honegger
Lead Group Strategy & Digital Transformation

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Allianz
Uniqa-Logo
msamlin
AmTrust-Logo
Claim Automation success stories in action

Case Studies

Why Omni:us?

omni:us is the leading provider of AI-powered End-2-End insurance claim automation. We are here to deliver the ultimate claims experience: for policy holders, as well as claims adjusters with adaptive processes to deliver speed, instant feedback & transparency, whilst drastically reducing process costs and reducing leakage across all channels.

More reasons to choose omni:us

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omni:us is proud to be one of Europe‘s Horizon2020 SME-Instrument and Fet Flag Champions.
We are grateful to have received funding from the European Union’s Horizon 2020 Research and Innovation Programme under Grant Agreement No 820323; 850053.

Co-financed by European Fund for Regional Development (EFRE)
Pro Fit-Project “Vollautomatisierung der Wertschöpfungskette im Digitalisierungsprozess von Archivdaten” with support of IBB/EFRE in 2016/2017.

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