AI-Powered Claims Optimization
Predict risks early, prevent escalation, and protect portfolio profitability.
Overview
Pinpoint’s AI-driven claims solutions detect high-impact scenarios at the earliest moment, whether at quote, FNOL, or during early handling. By surfacing key indicators like litigation potential, fraud propensity, and large-loss risk, carriers can act before costs escalate.
Seamlessly integrated into existing workflows, our models empower claims teams to allocate resources strategically, resolve cases faster, and deliver stronger policyholder experiences, while maintaining compliance and accuracy.
Reduce Severity Improving Closure Rates, and Protecting Portfolio Profitability.
With Pinpoint, claims teams shift from reactive handling to strategic management.
- Attorney Rep Propensity
- Litigation Propensity
- Fraud Propensity
- Large Loss Identifiers
- Cause of Loss Identifiers
Anticipate Legal Involvement Before It Happens
Our Attorney Rep Propensity model enables carriers to predict attorney involvement in claims at or immediately after first notice of loss – often before legal representation is confirmed. Using advanced attorney rep prediction analytics, the model highlights claims with elevated claim legal representation risk, allowing adjusters to take proactive action.
- Identify likely represented claimants early in the lifecycle
- Adjust communication strategy and resource allocation
- Improve claim outcomes by tailoring handling approach
Predict and Reduce Claims Litigation
Our Litigation Propensity model uses advanced litigation risk scoring to identify claims with potential for legal escalation early in the claims lifecycle. By leveraging claims litigation prediction, carriers can take proactive steps: involving legal counsel, adjusting reserves, or modifying settlement strategies, to reduce claim litigation severity and improve closure rates.
- Detect claims likely to escalate to litigation before it occurs
- Enable earlier legal intervention or reserve adjustments
- Improve closure rates and reduce severity
Detect and Prevent Fraud Early
Our Fraud Propensity model provides advanced insurance fraud prediction to flag suspicious activity across the policy and claims lifecycle. Using a fraud scoring model, carriers can detect potential fraud at quote, First Notice of Loss (FNOL), or any point during claims handling.
- Score for fraud risk at quote, FNOL, or during claims handling
- Strengthen underwriting decisions with early fraud signals
- Improve SIU targeting and investigation efficiency
Spot High-Exposure Claims Early
Our Large Loss Identifiers model enables carriers to predict large loss claims and detect high-exposure cases at or shortly after FNOL.
- Spot large-loss potential before it develops
- Assign specialized adjusters to high-exposure cases
- Reduce adverse development through early oversight
Detect Risk by Loss Type
Our Cause of Loss Identifiers use advanced loss cause analytics and claimant risk attribute models to detect heightened risk for specific causes of loss.
- Detect individuals with elevated risk for specific loss types
- Enable targeted claims handling by loss cause
- Support underwriting with pre-claim risk insights
Key Claims Benefits
Early Risk Detection
Identify litigation, fraud, and large-loss claims before costs escalate.
Proactive Management
Allocate resources strategically to improve closure rates and outcomes.
Portfolio Protection
Reduce severity, control costs, and safeguard profitability.
Frequently Asked Questions
How does Pinpoint’s claims optimization help carriers improve outcomes?
Pinpoint uses predictive AI models to detect high-risk claims scenarios early at the time of quote, First Notice of Loss (FNOL), or during initial handling. This enables proactive action on litigation, fraud, large-loss, and other risk factors, leading to faster resolution, better reserving, and reduced severity.
What types of risks can Pinpoint’s claims models identify?
Our models highlight key claims risk indicators including attorney representation likelihood, litigation potential, fraud propensity, and unexpected large-loss exposure.
Do the claims models require historical claims data to work?
No. Several of Pinpoint’s claims solutions, such as Attorney Rep Propensity and Litigation Propensity, require no historical claims data for deployment.
How do these solutions integrate with existing claims workflows?
Each model delivers predictive scores that plug into existing claims systems, either in the UI directly or in the backend through business rules and logic.
What benefits can carriers expect from AI-powered claims optimization?
Pinpoint’s claims solutions reduce litigation and fraud exposure, improve and accelerate reserving accuracy, increase closure rates with faster resolutions, and align resources to risk and complexity—protecting overall portfolio performance.
From Our Partners
Michael Lorion
CEO
“Pinpoint’s explainable visualizations reveal what drives human behavior, and also the interesting reasons why conventional data have missed the signal on this important issue. We see this as an important step forward in predicting behavior and ultimately reducing frictional costs and premiums.”
Vern Kirchhoff
SVP of Data Analytics
“Pinpoint’s automated platform unlocked 7 points of Loss Ratio improvement for our homeowners book for a 1-year implementation and, over the longer term, a larger bottom-line benefit as more of the book takes on the selected risk contours.”
Michael Pauletti
Senior VP & Chief Pricing and Actuarial Officer
“Pinpoint’s deep-learning platform allowed us to predict non-cat homeowners’ losses at the beginning of the customer journey for the first time.”
Analytics Team
“Pinpoint has provided game-changing new data to drive markedly improved loss ratios through better risk selection and claims handling.”
Rick Carter
Vice President, Analytics
“Above and beyond our latest pricing models, Pinpoint’s scores show material predictive lift for personal auto pure premiums.”
Chad Combs
VP of Personal Lines, Underwriting
“Pinpoint provided significant predictive advancement in the identification of a highly important loss exposure.”
Chris Strohl
Vice President, Underwriting
“We’re excited to partner with Pinpoint as we look at the opportunity to get deeper insights into our customers.”
Alice Robinson
Chief Actuary
“After just a few weeks of evaluating Pinpoint’s custom loss scores, we saw a significant improvement in loss ratio.”
Greg Godshall
President and CEO
“Pinpoint’s actuarial loss predictions will enable us to orchestrate the best experiences for agents and our customers.”
Fast-Track Profitable Growth
Data Science That Delivers Business Impact
Pinpoint is an AI company purpose-built for insurers. We combine deep actuarial expertise with modern data science to solve real-world problems across underwriting, marketing, and distribution. Our mission is simple: make insurance more precise and more profitable—one model at a time.