Atrium scales TPA oversight and claims-cost management with QualRisk
AI-Driven Intelligence for Commercial Insurance Claims
QualRisk AI helps Lloyd's managing agents, global insurers, and TPAs identify avoidable losses and optimize claims handling with traceability and evidence-based insights.
5-10% of claim losses are avoidable through better intelligence and oversight
Introducing Claims Pulse
AI-driven claims intelligence and audit platform for commercial insurance. Transform entire claim files into actionable insights with traceability to source.
Intelligent Ingestion
Handles large, messy files (PDFs, emails, images) and structures them for comprehensive analysis
Human-Quality Summaries
Generates concise, accurate summaries of complex claims that read like an experienced adjuster wrote them
AI-Driven Audits
Applies real claims audit frameworks across coverage, fraud, subrogation, reserving, and compliance
Next-Best-Action Insights
Recommends specific actions backed by evidence from the claim file—no black boxes
Portfolio Dashboards
Aggregated view with drill-down to individual claims and supporting evidence at document level
Ecosystem Integrations
Plugs into your existing claims systems, data lakes, and workflows with API-first architecture
Commercial Property: Escalating, Complex Claim
How Claims Pulse identifies critical issues in real-time that would otherwise go unnoticed for months
The Scenario
- 🔥Fire in commercial buildingArson suspected from initial investigation
- ⚠️Potential fraud identifiedBut insufficient evidence gathered to pursue
- 📈Reserve tripled over 24 monthsSignificant cost escalation went undetected
Claim Complexity
Claims Pulse Findings
1. Potential Fraud
AI-detected fraud indicators across multiple document types that were previously missed
2. Incomplete Subrogation
Subrogation investigation incomplete, missing key recovery opportunities
3. Handler Involvement Low
Initial claims handler involvement inadequate for the size and complexity of claim
If Claims Pulse was implemented, suspicious fraud activity and subrogation would be flagged in real-time with recommended actions.
$$$ at stake
Claims Pulse Market Deployment
This case study demonstrates how Claims Pulse addresses different market needs:
TPA/DCA Monitoring
There is a big need to evaluate the performance of third parties in their management of claims, to help influence authority levels, trust and to provide a tool to help TPAs/DCAs better manage their portfolio of claims, saving significant costs
Internal Peer Review
Supercharge your internal peer reviews – rather than a small selection of audit questions with limited data collected, collect full claim information, detailed reasoning and next-best-action to nudge claim adjustors to better decision making
Lloyd's Specific
Follow LMA audit items to ensure compliance with Lloyd's market requirements and managing agent obligations
Get Started with Claims Pulse
Contact us to schedule a consultation and discover how Claims Pulse can help your team identify avoidable losses and optimize claims handling.
Email Us Directly
Click below to send us an email with your consultation request. We'll respond within 24 hours.
Send Consultation RequestOr email us directly at: info@qualrisk.com
What to Expect
- Personalized 30-minute Claims Pulse demonstration
- Review of your specific claims intelligence challenges
- Discussion of integration with your existing systems
- No pressure—just insights on how we can help
Our Process
- 1.Consultation — We discuss your claims intelligence needs
- 2.Preview — Share 10 claims, bordereau, and audit goals
- 3.Launch — See Claims Pulse in action with your data
ISO 27001 & SOC 2 Type II Certified
Your data is handled with enterprise-grade security and confidentiality