Miami, FL — Claims teams face a compounding problem: nuclear verdicts, social inflation, and litigation funding have raised the cost of a wrong decision to its highest level in a generation. Meanwhile, claims professionals spend 40–60% of their time organizing, reading, and searching documents before making a single claim decision.
Wisedocs today introduced an AI-powered decision intelligence platform built to address that problem directly — moving carriers, TPAs, and legal teams from manual file review to structured, decision-ready intelligence across the full claims lifecycle, from intake and active care through escalation, litigation, and closure.
The platform turns complex claim documents into source-linked intelligence that surfaces risk signals, inconsistencies, and key insights early. It is built to handle even the most complex files, including claims exceeding 100,000 pages. The result is a new level of speed and confidence in claims outcomes. Organizations using Wisedocs report 60–80% faster first touch on complex claims and up to 2x case handling efficiency, enabling claims teams to move from document preparation to decision-making far earlier in the lifecycle. In existing deployments, including with a top P&C carrier, Wisedocs has reduced turnaround times by 85% and achieved 3x lower costs compared to previous BPO-based review processes — results the new platform is designed to extend and scale further.
Rather than forcing claims professionals to sift through thousands of pages to find risk signals or claim anomalies, the new platform surfaces the insights needed to act earlier. The platform highlights treatment outliers, litigation risk indicators, and claim inconsistencies such as missing records and contradictions that influence claim severity and outcomes.
Trusted by insurance carriers and organizations including TPAs, medical evaluators, law firms, and government programs, Wisedocs transforms document processing into decision intelligence for claims. The platform is already deployed across large claims organizations, including multiple Top 10 U.S. P&C and Disability Carriers, an HHS government claims program, and one of the largest state workers’ compensation insurers in the United States. Wisedocs is also a member of the Guidewire Insurtech Vanguards program, a curated community of insurtech innovators supporting the Guidewire global insurer ecosystem.
At launch, the platform centers on three core capabilities that prepare claims data, surface risk insights, and enable secure collaboration across the claims ecosystem.
WisePrep prepares claim files for investigation and review before a human opens them. The moment a file arrives, WisePrep automatically classifies documents across more than 1,500 medical, legal, and billing types, applies automated deduplication that removes 20-40% of page volume, generates structured medical timelines with gap detection, and delivers an organized case workspace within minutes. Early deployments demonstrate the ability to handle files exceeding 100,000 pages, scaling for catastrophic injury, medical malpractice, and multi-party liability cases.
Also included in WisePrep is WiseChat, which allows claims professionals to ask any question about the claim file in natural language and receive source-linked answers drawn directly from the underlying records.
