Smarter and faster claims decisions with Warranty Decision Intelligence

In today’s Warranty and Service Contracts (WSC) environment, claims teams need to make fast, accurate decisions while balancing loss ratio, customer experience, compliance, and fraud risk. However, the volume and complexity of data behind each claim have grown beyond what any human adjuster can reasonably process in real time.

Instead of relying on manual review and rule-based checks, AI-powered Warranty Decision Intelligence evaluates all available third-party and internal data simultaneously, including:

• Repair order line details and labor ops
• Diagnostic trouble codes and test results
• Telematics or usage data (where available)
• Parts pricing and supersession data
• Technician notes and historical repair patterns
• Uploaded images of damaged components
• Service history and prior claims behavior
• PIN, coverage terms, and contract exclusions
• External data sources (product reliability trends, recalls, Technical Service Bulletins (TSBs)

Claim Scoring: turning complexity into clarity

At the center of this approach is AI-driven Claim Scoring.  Each claim is assigned a dynamic score based on:

• Probability of validity
• Fraud or anomaly risk
• Repair appropriateness
• Cost outlier detection
• Historical precedent
• Contract policy alignment

This score gives your adjusters:

✔ A clear risk indicator before adjudication
✔ Recommended decision paths (approve, review, escalate, deny, request more information)
✔ Explanation of why the score was assigned
✔ Supporting evidence drawn from data correlations

Instead of reviewing every claim with the same intensity, your team can:

• Auto-approve low-risk, high-confidence claims
• Focus human expertise on high-risk or high-dollar cases
• Reduce leakage and inconsistent decisions
• Increase decision speed without sacrificing control

Benefits for WSC providers

Warranty Decision Intelligence enables you to:

• Improve loss ratio through precise adjudication
• Reduce cost-per-claim by automating low-risk approvals
• Catch subtle fraud patterns humans typically miss
• Standardize decisions across teams and geographies
• Create audit-ready, explainable decision trails
• Scale without proportionally increasing headcount

Most importantly, it shifts claims from reactive processing to proactive, data-driven decisioning.

Ready to improve claim decisions?

We’d love to show you how AI-powered claim scoring can be deployed alongside your existing admin platform with minimal disruption and measurable ROI within weeks.

Schedule a demo now to learn how you can improve the accuracy and consistency of claims decisions with AI-powered Warranty Decision Intelligence, while reducing the claims and administrative costs.