CLARA Analytics, an AI-driven solutions provider for the insurance industry, has rolled out advanced subrogation detection features in its flagship product, CLARA Triage, aimed at helping insurers recover significant funds lost through overlooked reimbursement opportunities.
The newly released capabilities are designed to tackle a long-standing industry problem: subrogation opportunities that go unrecognised due to fragmented workflows and inconsistent documentation.
According to estimates by the National Association of Insurance Commissioners (NAIC), the industry forfeits approximately $15 billion annually in missed subrogation recoveries.
CLARA’s AI technology seeks to close this gap by automatically identifying potential subrogation and risk transfer scenarios, scoring each case for financial potential, and offering clear, AI-generated explanations for claims professionals.
These enhancements allow insurers, third-party administrators (TPAs), and self-insured organisations to focus on the most promising cases. As claims data evolves from first notice of loss through resolution, CLARA Triage continuously updates its insights, triggering alerts when a case crosses a threshold worth pursuing for recovery.
CLARA’s models are trained on a vast, shared database built from the experiences of multiple insurance carriers, giving it a deep understanding of medical, legal, and financial risk factors. The AI platform also pinpoints where recoveries are most likely — and most valuable.
Clients who have adopted CLARA Triage have already reported 2% to 5% improvements in their combined ratios over a 12-month claims cycle. CLARA also provides regular ROI reports to its clients, showing a typical return of 500% or more, with some users reporting even greater performance gains.
“CLARA’s core values include constant innovation and an obsessive focus on our customers’ needs,” added Heather H. Wilson, CEO at CLARA Analytics.
“The market has a significant gap in regard to subrogation opportunity identification. Our mission is to transform the way claims management teams work with their subrogation partners to deliver transformative financial results. Our new subrogation detection capabilities are a major step forward in that journey.”
“CLARA’s company culture is all about reaching higher, always looking for ways to add more value for our customers,” Wilson continued.
“With these new subrogation and risk transfer detection capabilities, we can help insurers achieve even higher ROI.”
