The Operating System for Claims Services

The Patented AI-Powered
3rd Party Claims Service Orchestration
Platform

Reduce Loss Adjustment Expense. Optimize vendor performance. Improve claims outcomes across your entire P&C and Workers' Compensation service ecosystem.

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"Where Claims, Vendors, and Outcomes Converge."

Claims. Vendors. Performance. Orchestrated.

Route smarter, spend less, close every claim.

Rules Engine
WC Medical — Preferred Panel
● Active · 847 assignments
Capacity Balancing
● Active · 123 redirects
Service Providers
#ProviderScoreSLA
1Concentra Medical9698%
2Mitchell Network9195%
3Express Scripts8892%
Executive Overview — Last 20 Days
Total Claims
12,845
↑ 8.4%
Total Savings
$7.10M
↑ 12.3%
SLA Compliance
94.2%
↑ 2.8%

The Challenge

Billions are spent on claims service providers — yet management stays manual.

Claims vendor management is manual, inconsistent, and hard to measure — leaving leaders without the answers that drive outcomes. LAElia changes that, in real time.

  • Which vendors drive the best outcomes?
  • Which vendors deliver the most value?
  • Are assignments matched to expertise and capacity?
  • Where are the opportunities to reduce LAE?
  • Which vendors deserve more — or fewer — assignments?
  • Are preferred vendor programs being honored?
View Solutions →

Results

Measurable results carriers can put on the board

01

Lower loss adjustment expense

LAElia pinpoints and eliminates inefficiencies across your vendor network to bring LAE down, claim after claim.

02

Vendor accountability

Hold every vendor to objective, measured performance — so your best providers earn more work and weak ones improve or move on.

03

Faster claim resolution

Route each claim to the right provider and balance capacity, so cycle times shrink and claims close sooner.

04

Continuous improvement

A claims ecosystem that gets smarter over time — powered by AI and your own outcome data.

Explore the Vendor Ecosystem →

The Platform

Everything claims leaders need, in one place

Real-time visibility into every dollar of LAE

One executive view across all claims, vendors, and service categories. Track savings trends, SLA compliance, and provider performance — with date-range filters and exportable reports for leadership.

  • LAE savings trends by service category
  • Medical, indemnity & field savings breakdown
  • SLA compliance tracking across all providers
  • Service Provider Performance scorecards
Executive Overview — Last 20 Days
Total Claims
12,845
↑ 8.4%
Total LAE
$45.6M
↑ 4.7%
Total Savings
$7.10M
↑ 12.3%
SLA Compliance
94.2%
↑ 2.8%
LAE Savings Trend
Service Savings
Medical Bill Review$1.85M
Network Optimization$1.32M
Pharmacy Carve-Out$1.15M
DME & Supplies$980K

Route every claim to the right vendor, automatically

The Claims Orchestrator applies your business rules and vendor intelligence to make assignment decisions in real time — eliminating manual routing and ensuring the best provider gets every job.

  • AI-powered vendor matching by claim type and geography
  • Capacity balancing across your entire panel
  • Business rules enforcement on every assignment
  • Full audit trail for compliance and reporting
Claims Orchestrator
Incoming Claims Queue
NEWWC-2026-04891 · Medical Mgmt
ROUTEDWC-2026-04890 · Field Adj.
ROUTEDGL-2026-03221 · Defense
NEWWC-2026-04889 · Pharmacy
AI Routing Decision
Recommended Vendor
Concentra Medical
Score: 96 · SLA: 98%
Matched on: specialty, geography, capacity, outcome history

Score, rank, and manage your entire vendor network

LAElia gives you a complete performance picture of every service provider — from onboarding through ongoing scorecard tracking. Your best vendors earn more work; underperformers improve or move on.

  • Vendor scorecards by overall score, SLA, and cycle time
  • Automated onboarding workflows
  • Preferred panel enforcement across all assignments
  • KPI benchmarks by service category
Service Provider Performance Overview
#ProviderScoreSLACycle
1Concentra Medical9698%4.2d
2Mitchell Network Opt.9195%3.8d
3Express Scripts PBM8892%2.1d
4Broadspire IA8489%6.5d
5Sedgwick Claims Mgmt8187%7.2d

Encode your claims strategy into the platform

The Rules Engine translates your carrier's vendor strategy, compliance requirements, and preferred panel agreements into automated decision logic — enforced consistently on every claim, every time.

  • No-code rule builder for claims operations leaders
  • Preferred panel and contract enforcement
  • Jurisdiction and state-specific routing rules
  • Audit logs for compliance and regulatory reporting
Rules Engine — Active Rules
WC Medical — Preferred Panel
IF claim_type = WC AND service = Medical → assign from preferred_panel WHERE score ≥ 85
● Active · 847 assignments this month
Capacity Balancing
IF vendor.current_load ≥ 90% capacity → route to next_best_vendor
● Active · 123 redirects this month
SLA Escalation
IF vendor.sla_compliance < 80% (30d) → flag for review AND deprioritize
● Active · 3 vendors flagged
Explore the Platform →

The impact is measurable

Real results carriers can put on the board

Total Savings Captured

$7.1M+

Per deployment — in documented LAE reduction across medical, legal, field, and specialty services.

SLA Compliance

94.2%

Average across all claim service categories

Service Categories

15+

Managed end-to-end in a single platform

Medical · Legal · Field · Technical · Investigative · Specialty

Claims Orchestrated

12K+

Claims routed, tracked, and measured through the platform

LAE Savings Growth

+12.3%

Period-over-period improvement in savings captured

Introducing Claims Service Orchestration™

A new approach to managing the claims ecosystem

Every assignment becomes measurable.

Every vendor becomes accountable.

Every dollar of LAE becomes visible.

See how LAElia reduces LAE and improves outcomes

Schedule a personalized demonstration and see how carriers reduce expense, improve vendor performance, and deliver better claims outcomes.

Request Demo

Trusted by P&C and Workers' Compensation carriers

Midwest Carriers Regional Mutual Coastal Claims Group Summit Insurance Pacific Risk Partners Liberty Claims Co.