AI-Powered Framework for Smarter Claims
Give Your Claims an IQ Boost
Claims Intelligence accelerates claims processing by automating routine tasks to cut delays, reduce errors, and lower costs. Free your team to focus on complex, high-value claims and deliver better service at scale.
Define rules for any product type to target claims you want to automate
Trigger actions like authorize, pay, or calculate severity
Move at your pace toward straight-through claims processing
The 3 Pillars Driving Transformation
Automation IQ
Rule-based AI Workflows That Automate Claim Decisions
Automating authorization, payment, and denial actions through configurable rules. It streamlines operations, reduces manual effort, and enables your team to manage higher claim volume with greater speed and accuracy.
Insights IQ – coming soon
Predictive Intelligence Built on the Industry’s Richest F&I Dataset
Insights IQ transforms PCMI’s industry-leading warranty data into actionable analytics. With real-time trend detection and historical depth, it helps F&I teams surface risks, refine strategies, and drive smarter decisions across the full claims lifecycle.
Workforce IQ – coming soon
Intelligent Routing That Maximizes Team Performance
Workforce IQ routes claims based on complexity, workload, and expertise ensuring the right adjuster handles the right task. It improves resolution times, balances productivity across teams, and helps you scale efficiently without overextending resources.
Automation IQ
Rule-based AI Workflows That Automate Claim Decisions
AI that reads, validates, and pays claims—instantly
Automate claim invoice processing with AI that reads service invoices, validates them against approved claims, and issues instant payment. Set custom rules by product type to control automation, eliminate manual work, and reduce costs.
Drive Down Back-Office Costs
Automate invoice matching and payment to reduce administrative overhead at scale
Enforce Partner-Specific Rules
Apply configurable logic to ensure every payout aligns with contract terms
Prevent Errors Before They Happen
Use real-time checks to catch issues early and eliminate overpayments
Free Up Teams for Strategic Work
Let automation handle the routine so your staff can focus on complex claims and program growth
Impact
90
K
annual cost savings per 100k claims
5
K
annual hours reclaimed per 100k claims
$
.90
per claim saved
3
x
productivity boost
3
min
per claim saved
More logic. More control.
More automated decisions.
Claims Intelligence delivers advanced, configurable decisioning workflows that let teams’ model real-world claim complexity, without code. Using a powerful orchestration engine and manager, users define how claims are evaluated, authorized, what actions are taken, and when automation runs.
Orchestrated Decisioning at First Touch!
Make authorization decisions the moment a claim is submitted. The orchestration engine evaluates coverage, eligibility, limits, and risk together to automatically approve, deny, request more information, or escalate, ensuring consistent outcomes across products and programs.
Configure, Manage, and Evolve Rules Centrally
Control your authorization logic without code or system changes. Use the claims orchestration manager to build, test, and update rules with clear guardrails by product, claim amount, partner, or risk profile, without redeployment or disruption.
Orchestrated by Design
Behind the scenes, the orchestration engine connects internal systems, PCRS Actions, and third-party intelligence to drive consistent decisions at scale. It supports complex, multi-step claim journeys and adapts easily as new data sources, tools, or AI models are added.
Prevent Leakage Before Authorization Occurs
Stop unnecessary spending before work is approved. Enforce policy limits upfront and block unauthorized repairs in real time to reduce disputes, rework, and payment corrections later.
Scale Authorization Without Scaling Staff
Handle growth with orchestration; not headcount. Centralized rules ensure consistent authorization of decisions across teams and regions while supporting higher claim volumes without operational drag.
Impact
210
K
annual cost savings per 100k claims
11
K
annual hours reclaimed per 100k claims
$
2.10
per claim saved
6
min
per claim saved
85
%
time reduction