Claims are the moment of truth in any insurance relationship — a slow, opaque or inconsistent claims experience erodes customer trust faster than any other touchpoint, and it inflates loss-adjustment expense for the insurer. Redian's AI-based claims management software gives insurers, MGAs and brokers a single, configurable workspace for the full claim lifecycle, with AI threaded through it: ML-driven triage and severity scoring, document AI on police abstracts, medical reports and invoices, LLM-powered adjuster copilots, and configurable fraud-detection models trained on the insurer's own claims book. The same engine handles the entire lifecycle — from First Notice of Loss (FNOL) through adjudication, fraud screening, settlement and recoveries.
This page is for heads of claims, COOs and CIOs at carriers, MGAs and brokers in Kenya, India, the UK, the UAE and the wider African and South Asian markets. We work across motor, health, marine, fire, liability and life — and across direct, broker-led and aggregator-led distribution.
What the platform does
The platform is designed for the realities of multi-channel, mixed-language claims operations: USSD, WhatsApp Business, branch, broker portal, mobile app — into one queue. English and Swahili correspondence. Mobile-money payouts alongside RTGS and cheque. Reporting obligations under the Insurance Regulatory Authority of Kenya (IRA-Kenya), IRDAI in India, NAICOM in Nigeria, CIMA in francophone West Africa, the FCA in the UK, the Central Bank of the UAE and the FSCA in South Africa — out of the box.
1. Omnichannel FNOL intake
- Customer self-service via web portal, mobile app, WhatsApp Business, USSD and SMS
- Branch and call-centre intake screens with guided scripts and prompt validation
- Broker and agent portals with pre-validated submissions and policy lookup
- Automatic policy validation, cover check and duplicate-claim detection at the point of capture
2. Triage and assignment
- Rules-based routing to in-house adjusters, third-party administrators or panel surveyors
- Severity scoring to fast-track low-value, low-complexity claims for straight-through processing
- SLA clocks, work-queues and escalation matrices so nothing sits past its due date
- Geo-routing of surveyors and assessors against the location of the loss
3. Adjudication and reserving
- Configurable adjudication workflows per line of business: motor, health, marine, fire, liability, life
- Reserve setting with audit trail, multi-currency support and approval thresholds
- Integration with repair networks, hospitals and salvage vendors for live status updates
- Document management with OCR for police abstracts, medical reports, invoices and quotations
4. Fraud detection
- Rule library covering common red flags: late reporting, repeat claimants, suspicious geolocation, mismatched documents
- Network analysis to surface relationships between claimants, providers and intermediaries
- Optional ML scoring trained on the insurer's historical book
- Case management for the Special Investigation Unit with evidence locker and chain-of-custody logs
5. Settlement and payouts
- Multi-channel disbursement: M-Pesa, Airtel Money, bank EFT, RTGS, NEFT, IMPS and cheque
- Automated discharge voucher generation and digital signature capture
- Salvage, subrogation and recovery tracking, including reinsurer share allocation
- Tax handling for withholding tax, GST and VAT on service provider payments
6. Reinsurance and co-insurance
- Treaty and facultative cession at the claim level
- Automatic bordereaux generation for reinsurers in the formats they require
- Co-insurance leader/follower workflows with share-based document distribution
- See reinsurance placement for the full ceding workflow
Regulator coverage
Reporting templates and audit trails are aligned to IRA-Kenya, IRDAI, NAICOM, CIMA, FCA, FSCA and the Central Bank of the UAE. Quarterly and annual returns — claims paid, claims outstanding, IBNR triangles, complaints registers — are generated from the live transaction store, not bolted on after the fact. Audit trails are immutable and timestamped, so both internal audit and regulator inspections see the same evidence.
Data residency options let insurers keep PII inside the country of operation, in line with Kenya's Data Protection Act 2019, India's DPDP Act 2023 and equivalent frameworks across the markets we serve.
Integration with the wider insurance stack
Claims rarely live in isolation. The platform exposes REST and SOAP APIs and ships with pre-built connectors for:
- Policy administration systems — Premia, Genisys, Odoo Insurance and in-house mainframes
- Underwriting and pricing engines — including our own ML-based rating engine
- General ledgers and ERPs — SAP, Oracle, Microsoft Dynamics, Odoo, Sage
- CRM and contact-centre platforms — Zoho CRM, Salesforce, SuiteCRM, Freshdesk, Genesys
- Document and e-signature platforms
- Mobile money aggregators and bank payment gateways for payouts
- Reinsurance accounting systems
Where it fits
We deploy this for three buyer profiles:
- Tier 2/3 carriers in Africa and South Asia replacing legacy claims platforms or stitching together a Frankenstein of spreadsheets, email and a 15-year-old PAS.
- MGAs and broker-led distribution that need a defensible claims workspace they can show to capacity providers and the regulator without apology.
- Aggregators and microinsurers running high-volume, low-ticket claims where straight-through processing economics decide whether the book makes money.
Why Redian
Claims technology is unforgiving — a settlement workflow that fails on payday means customers don't get paid, and the carrier's NPS collapses in a single week. We engineer this platform with the operational rigour insurance demands: paired-environment deployments, blue/green release for the operations console, full ASV/PT before each production cut, and 24x7 NOC support across our Nairobi, Noida and Dubai hubs.
We've shipped policy, claims and broker work for carriers, MGAs and aggregators across India, Kenya, the UAE and the UK since 2016 — see the broader insurance practice and our BFSI case studies. Our engineers understand the regulator-facing reporting (IRA-Kenya, IRDAI, NAICOM, CIMA, FCA) and the payout rails (M-Pesa, NEFT, RTGS, IMPS) that make or break a deployment.
Where you need to extend the bench, our staff augmentation and GCC models put Redian engineers alongside your in-house team under your governance.
Working with Redian
Most claims programmes we take on are 12–16 weeks to first live line of business and 6–8 months to a full multi-LOB rollout, depending on PAS integration depth and the volume of historical claims to migrate. We'll scope yours against your existing PAS, your regulator's specific claims reporting expectations and the channel mix you actually serve.
Talk to our insurance team about your claims roadmap, or browse our insurance case studies for comparable rollouts.