Processing claims autonomously

The adjudicator that never sleeps, never misreads a rule

Adjuva is an AI agent that reads claims, applies policy rules, determines eligibility, and renders decisions. Built for disability insurers, TPAs, and benefits administrators who process thousands of claims with teams that can't scale.

The Problem

Claims adjudication is the bottleneck nobody talks about

Every insurer and TPA has the same story: experienced adjusters retiring faster than new ones can be trained. Complex eligibility rules spread across binders nobody has fully read. Backlogs measured in months. And every delayed decision is a person waiting for benefits they may desperately need.

The enterprise solutions cost six figures and take a year to deploy. Mid-market organizations are stuck choosing between expensive consultants and spreadsheets. Neither works.

$1.6B
AI claims adjudication market in 2024, growing rapidly year over year
15-20%
of claims still require human adjudicators due to complexity and ambiguity
60%
reduction in claim cycle time when AI handles eligibility determination
How It Works
01

Ingest the claim

Adjuva reads the full claim file: medical records, application forms, supporting documents. It extracts the facts that matter for the eligibility decision, structured and ready for adjudication.

02

Apply policy rules

Every policy has rules, exclusions, waiting periods, and sub-limits. Adjuva maps the claim against the applicable policy logic and regulatory requirements, the same way an experienced adjudicator would.

03

Render the decision

Approve, deny, or escalate. Every decision comes with a full rationale: which rules applied, what evidence supported the outcome, and why. Auditable from day one.

04

Learn and improve

When human reviewers override a decision, Adjuva learns. It tracks appeal outcomes, adjudicator corrections, and edge cases to continuously sharpen its accuracy on the claims that matter most.

Built by someone who adjudicates claims for a living

Adjuva isn't built by engineers guessing what adjusters need. It's built from the inside, by someone who processes disability and benefits claims every day, and knows exactly where the system breaks.