AI-Powered Claims Assessment & Pre-Existing Condition Platform

Knose's claims process relied heavily on manual effort — assessors had to read and interpret vet invoices, identify pre-existing conditions, and manually calculate reimbursements before contacting customers.

As claim volumes grew, so did turnaround times and administrative strain. Without automation, the team faced a hard limit on scalability.

Customer expectations for faster reimbursements were rising, and growth required new hires — an unsustainable long-term model.

Kipanga mapped the full claims lifecycle — from customer vet invoice upload to final payment approval. Discovery sessions with operations and assessment teams uncovered key friction points where automation could make the biggest impact.

A secure, serverless platform was built with intelligent data extraction to identify and structure key details like diagnosis codes, treatment types, and policy references.

Flexible rule logic allows business teams to update assessment criteria without code changes.

A custom software platform that captures customer submissions via streamlined digital forms, extracts key data from vet invoices using AI, and presents assessors with an intuitive dashboard for rapid decision-making.

Payment calculations and customer communications are automated through built-in workflows and templates. Integration with policy databases enables real-time coverage checks.

The platform was built in partnership with Knose IT and compliance teams, meeting ISO 27001-aligned data security and privacy standards.