i3systems.ai: Revolutionizing Health and Life Insurance Claims with AI-Powered Automation

i3systems.ai is a cutting-edge technology platform designed to streamline health and life insurance claims processing through the integration of Robotic Process Automation (RPA), Intelligent Document Processing (IDP), and advanced AI. Tailored for premium private insurance customers, it enables end-to-end automation of claims and policy management, delivering faster, more accurate adjudication while enhancing customer experience and reducing payment leakages. With a proven track record of processing over 5 million claims across 60,000+ hospitals and 10,000+ diagnostic centers in India, the platform excels in automated data classification, clinical and financial underwriting, hospital tariff comparison, and fraud, waste, and abuse (FWA) detection. Its customized algorithms ensure compliance with IRDAI regulations, while LLM-powered document processing extracts critical line items with precision. Built on a foundation of flexible deployment, robust security, and continuous innovation, i3systems.ai is a trusted solution within the Connect & Heal Enterprise.

Key Features:

• AI-led financial and medical underwriting
• Automated financial and clinical adjudication
• Document processing with auto-categorization and LLM-powered line item extraction
• Automated classification and standardization of claims data
• Hospital tariff comparison for accurate billing validation
• Fraud, waste, and abuse (FWA) audits with intelligent detection
• Pre-policy checks using financial parameters for seamless digital underwriting
• Customized algorithms for business rule application and IRDAI compliance
• Detection of upbilling by comparing bill line items against contract tariffs
• Flexible solutioning and curated deployment options
• Best-in-class information security and continuous innovation support

Pricing: Premium private insurance customers benefit from a subscription-based model tailored to enterprise needs, with scalable solutions designed for high-volume, high-compliance environments.

Conclusion: i3systems.ai stands as a transformative force in insurance technology, combining AI, RPA, and IDP to deliver intelligent, secure, and efficient claims processing—setting a new benchmark for accuracy, compliance, and customer satisfaction in health and life insurance.