With a mission to streamline and accelerate claims handling while maintaining the highest standards of accuracy and compliance, SBS Claims serves insurance carriers seeking to enhance operational efficiency and customer satisfaction. The company processes thousands of claims monthly across multiple insurance lines, making them a perfect candidate for AI-driven transformation.

Challenges

SBS Claims faced significant operational hurdles in their quest to scale claims processing:

• Manual processing bottlenecks: Claims handlers spent excessive time reviewing each claim, limiting daily processing capacity

• Regulatory compliance concerns: Initial experiments with LLM-based AI solutions failed because the explanations generated were not regulatory-ready

• Accuracy requirements: The insurance industry demands near-perfect precision in claims decisions, which traditional AI couldn't deliver

• Audit trail limitations: Existing AI solutions operated as "black boxes," making it impossible to understand or explain decision-making processes to regulators and customers

Their attempt to implement traditional LLM solutions revealed a critical gap: while these systems could process claims, their low accuracy rate meant every decision required manual verification, negating any efficiency gains.

Solution

UnlikelyAI deployed its groundbreaking neurosymbolic AI platform, specifically designed for regulated industries requiring absolute precision and transparency. The solution combined:

Core technology

• Neurosymbolic architecture blending machine learning with deterministic logic

• Proprietary precision engine delivering 99%+ accuracy on definitive answers

• Complete audit trail generation for every decision made

Key capabilities

• Natural language processing for understanding complex claims documentation

• Rule-based reasoning system for consistent, explainable decisions

• Intelligent triage system that identifies claims requiring human review

• Seamless integration with SBS Claims' existing workflow management systems

Results & impact

The implementation delivered transformative results that exceeded initial projections:

Quantitative metrics

1.7x increase in claims processing capacity: Claims handlers can now process 70% more claims in the same timeframe, with this increasing as UnlikelyAI’s model improves

• 100% explanation rate: every claim gets assessed against every clause ensuring an explanation trail which is an accurate representation of how the answer was reached

• 99% precision rate: When UnlikelyAI provides a definitive answer, it's correct 99% of the time (vs. 52% for traditional LLMs)

• 100% consistency: Same claim, same answer - every time (compared to ~10% inconsistency with LLMs)

Qualitative benefits

• Complete regulatory compliance with full audit trails for every automated decision

• Significant reduction in manual errors

• Claims handlers freed to focus on complex, high-value cases

• Enhanced customer satisfaction through faster, more consistent claim resolutions

The bottom line

SBS Claims' partnership with UnlikelyAI demonstrates that regulated industries don't have to choose between AI efficiency and compliance requirements. By implementing neurosymbolic AI technology, SBS Claims achieved a 1.7x increase in processing capacity while maintaining 99% precision and full regulatory compliance - proving that trustworthy AI isn't just possible, it's transformative.

“We’ve always prioritised excellent customer services and using technology as an enabler for that. UnlikelyAI’s neurosymbolic approach stood out as a game-changer for our operations, with this partnership allowing us to deliver a faster, more reliable service to our customers whilst maintaining our human touch where it matters most. We’re excited to lead the way for this milestone in InsurTech and are proud to be setting new industry standards for intelligent claims processing.”

- Bazil Crowley, Director of Innovation at SBS Insurance Services