Insurance claim file duplicate-event resolver
Reduce duplicate administrative handling without rejecting valid claims.
- For
- Claims administration teams
- Solves
- Related event records are treated as unrelated cases or false duplicates.
- Delivers
- Claims-professional-reviewed event linkage queue
- Built in
- about 5 weeks of creation time, MVP in 6 days
- Investment
- $21,000 for the MVP, $50,000 for the full product
- Run it
- Inside your business, or as part of your offer to clients
What it does
Reduce duplicate administrative handling without rejecting valid claims.
- Propose event links.
- Preserve conflicting evidence.
- Prepare reviewer merge decisions.
- Compare the reviewed result with the recorded baseline and value assumptions.
- Capture corrections and named-owner approval before consequential use.
- Export a versioned claims-professional-reviewed event linkage queue with source references and unresolved questions.
What goes in, what comes out
- Authorized incident references
- Expert-labeled examples
AI drafts, people review. Evidence review and quality assurance workspace.
- Claims-professional-reviewed event linkage queue
How it works
The workflow
- InStart with
Authorized incident references and expert-labeled examples
- 1
Confirm the buyer's problem and scope
- 2
Collect authorized incident references and expert-labeled examples
- 3
Then follow this sequence: 1
- OutFinish with
Claims-professional-reviewed event linkage queue
AI does the heavy lifting, people stay in charge
Use AI to interpret permitted inputs, suggest structured mappings and generate candidate outputs for the three stated task modules. Use deterministic code for arithmetic, schema validation, hard constraints and reproducible tests. Review source-linked explanations and uncertainty before accepting results. No fraud labeling or automatic claim merge or denial. A model suggestion is never a verified fact, professional decision or authorization to act.
What your team sees
Primary screens: Submission and rules, Evidence-linked exceptions, Reviewer decisions and export. Open on a review queue ordered by reviewer-selected priorities. Show each finding beside the original evidence and applicable rule. Provide accept, dismiss and needs-information controls with reasons. A separate report view summarizes confirmed findings and unresolved items, not raw AI flags. Make the task-specific outcome claims-professional-reviewed event linkage queue visible beside its evidence, review state and value baseline.
Accounts and administration
Versioned review criteria, evidence links, reviewer decisions, disagreement handling, correction assignments, recheck status and exportable review history. Add organization access boundaries, named reviewers, usage caps, data retention controls, export logs and explicit approval for external actions.
Integrations and data access
Broker-approved policy documents, case records and carrier requirements. Source repositories, task trackers and report exports. Keep findings as review proposals until authorized owners accept the resulting actions. Start with authorized file exchange. Validate current provider access, usage rights and schema behavior before promising a connector.
How we build it
We build with our own AI software development factory, so most implementations take days to a few weeks of creation time, not months. You see working software at every step, and exact timing depends on availability.
- 1
Scoping call
Day 1Thirty minutes on your process, your data and how you want to run it: for your own team, or for your clients. You get a fixed scope and price for the MVP.
- 2
MVP
6 daysOne buyer segment, one recurring use case; first modules: propose event links; preserve conflicting evidence. Manual review in the loop. Built by our AI software factory.
- 3
Paid pilot
7 daysAccounts, roles, review states, audit trail and the first integration, hardened for two to three paying pilot customers.
- 4
Full product
3 weeksSelf-serve onboarding, billing, monitoring and the wider integration set.
- 5
Run and improve
MonthlyWe host, monitor and improve it for a fixed monthly fee, or hand it over to your team. How the retainer works.
Why we start with an MVP
An MVP, or minimum viable product, is the smallest version that your users can actually work with. It is not a cheap version of the full solution. It is a test, built to answer the questions that decide whether the rest is worth building.
- Pick the riskiest assumption. Here: will claims administration teams use it to solve "related event records are treated as unrelated cases or false duplicates"?
- Build only what tests it. One team, one use case, a few core modules. People do the rest by hand for now.
- Run a paid pilot. Agree quality and outcome thresholds before the pilot using this measure: Confirmed duplicate work avoided minus linkage review and correction cost.
- Measure, then decide. Track confirmed duplicate work avoided minus linkage review and correction cost; accepted-output rate; material error rate; reviewer correction time; actual repeat purchase. Then expand, change course or stop, with evidence instead of opinions.
MVP scope for this solution. Pilot scope: No fraud labeling or automatic claim merge or denial. Implement one approved input format, a bounded representative case set and the first two task modules: propose event links; preserve conflicting evidence. Support the third module with operator review: prepare reviewer merge decisions. Include source references, corrections, basic organization access, approval states, export and value measurement. Use managed operator assistance for unresolved exceptions. The cost estimate covers this narrow prototype, not unrestricted multi-tenant scale, complex production integrations, specialist certification or physical operations.
After the MVP. Once paid pilots prove usefulness, automate repeatable reviewed steps and add one verified source integration. Expand supported inputs and case volume only after new evaluation cases pass. Build reusable customer configurations and recurring value reports around claims-professional-reviewed event linkage queue. Retain the explicit scope boundary: No fraud labeling or automatic claim merge or denial.
What the build depends on. Evidence coordinates, versioned rules, reviewer decisions and a representative reference set. Measure misses as well as confirmed findings before scaling. Obtain representative authorized cases, baseline measurements, qualified reviewers and a buyer-side decision owner. Specific limitation: No fraud labeling or automatic claim merge or denial.
Investment
A planning range to start the conversation, not a quote. You pay per phase, so you can stop after the MVP.
- Phase 1
MVP
One buyer segment, one recurring use case; first modules: propose event links; preserve conflicting evidence. Manual review in the loop.
- Phase 2
Paid pilot
Accounts, roles, review states, audit trail and the first integration, hardened for two to three paying pilot customers.
- Phase 3
Full product
Self-serve onboarding, billing, monitoring and the wider integration set.
Indicative total, MVP to full product$50,000about 5 weeks of creation time · start with the MVP from $21,000
Running costs per month
A rough indication of monthly hosting and AI model costs once it is live, not tested. Real costs depend on usage, file sizes and the models chosen.
| Stage | Hosting and infrastructure | AI usage | Total per month |
|---|---|---|---|
| MVP and paid pilotabout 3 customers | $50–$100 | $80–$160 | $130–$260 |
| Full productabout 50 customers | $190–$380 | $880–$1,750 | $1,070–$2,130 |
Run it or resell it
For your own team
Claims administration teams run it inside the business: authorized incident references and expert-labeled examples in, claims-professional-reviewed event linkage queue out, reviewed by your people.
As part of your offer
Agencies, consultancies and software companies can offer it to their own clients under their brand. We build and maintain it; you sell and deliver it.
Your brand, or this one
Run it under your own brand, or start from this concept style.
- primary
#279185 - accent
#c95c54 - surface
#e4f1ef - ink
#22201e
- Headings
- Sora
- Text
- Work Sans
- Voice
- Reassuring, clear, no small print
Selling it to your own clients: the go-to-market playbook
Pricing to test
Test USD 500-2,000 for a defined audit sample and report. Offer recurring review priced by reviewed items and specialist hours. Software-only access can follow a reliable reviewed service. All prices require validation. Package the initial sale as one bounded claims-professional-reviewed event linkage queue. Recurring fees must specify volume, review depth and integration support. For exchanges, test a disclosed coordination or successful-service fee rather than holding customer funds. Reprice only after measuring real delivery labor; platform-build cost is separate from a commercial pilot fee.
Message to test
Reduce duplicate administrative handling without rejecting valid claims. Demonstrate a concrete claims-professional-reviewed event linkage queue using the buyer's approved example and show the baseline, corrections and actual delivery effort.
Where to find buyers
Claims administration teams professional communities; specialist consultants serving this buyer; permissioned partner introductions; practical demonstrations at relevant trade or practitioner events.
Lead magnet
A reviewed sample claims-professional-reviewed event linkage queue from a small authorized input set, with a transparent calculation of confirmed duplicate work avoided minus linkage review and correction cost and no promised savings.
The first 30 days
- Week 1: interview five claims administration teams and inspect a recent example of related event records are treated as unrelated cases or false duplicates.
- Week 2: prepare a consented or synthetic demonstration of the three task modules.
- Week 3: seek one bounded paid pilot with agreed baseline and acceptance criteria.
- Week 4: measure confirmed duplicate work avoided minus linkage review and correction cost, reviewer effort and repeat-purchase interest. This is a demand-validation plan, not a thirty-day full-product delivery promise.
Paid pilot
Agree quality and outcome thresholds before the pilot using this measure: Confirmed duplicate work avoided minus linkage review and correction cost. Continue only if the buyer accepts the actual output, the intended job outcome improves without unacceptable errors, and measured delivery cost fits willingness to pay. Revise or stop if access is unavailable, qualified review cannot be provided, or apparent savings disappear after corrections and support. Use held-out cases when comparing model quality; use a properly reviewed comparison design before making causal claims. Record missing cases and negative results alongside successful outputs.
Success metrics
Confirmed duplicate work avoided minus linkage review and correction cost; accepted-output rate; material error rate; reviewer correction time; actual repeat purchase.
Retention and expansion
Repeat the workflow when the buyer again needs claims-professional-reviewed event linkage queue. Retain permissioned settings and reviewed examples, report realized value honestly, and sell increased volume or adjacent approved workflows only after contribution margin and quality remain acceptable.
Why clients would pick it
A domain-specific review rubric and rights-cleared examples of confirmed defects, false alarms and reviewer reasoning. Build a permissioned library of representative task cases, reviewer corrections and verified operating constraints for claims administration teams. Repeatable delivery and useful integrations matter more than access to a base model.
Alternatives and positioning
Manual reviewers, checklists, generic scanning tools and specialist audit services. Compare this product with the buyer's present method on confirmed duplicate work avoided minus linkage review and correction cost. Offer a bounded paid workflow instead of claiming broad autonomous expertise. Market uniqueness and competitor coverage are not verified.
Main delivery costs
Document or media processing, model evaluation, expert review, false-positive handling, rechecks and customer-specific rubric calibration. Additional initial validation requires representative authorized sample preparation, buyer interviews, qualified domain review and bounded validation of claims-professional-reviewed event linkage queue. Track cost per accepted output, including correction work, unsuccessful cases and support.
Safeguards
Separate document preparation from coverage, underwriting and claims decisions. Authorized professionals review policy meaning and customer commitments. No fraud labeling or automatic claim merge or denial. Keep all consequential actions under authorized human control and do not fabricate missing inputs, permissions, professional judgments or market evidence.