AI-Driven Insurance Claim Automation & Assessment SaaS
The CTO of a fast-growing startup is working on an AI-based insurance claims assistant. This product can assess claims for any policy with remarkable accuracy in just seconds, using an LLM API as part of a more complex, proprietary system. It's been tested on real, PII-scrubbed claims data from a major insurance company. They're looking for a CEO to help bring this to market, seeing a clear B2B SaaS opportunity. The goal is to target insurance companies, helping them automate and greatly enhance the efficiency, accuracy, and speed of their claims processing. This could reduce operational costs and improve decision consistency. The CTO's technical expertise, combined with the insights of a senior claims officer, brings both the technical and industry know-how needed. The SaaS would likely be subscription-based, with different tiers based on claim processing volume, number of users, or specific feature sets, such as types of insurance covered and advanced analytics.
Origin Reddit Post
r/startups
Looking for advice + CEO! - i will not promote
Posted by u/kennyg293•06/03/2025
For some context, Im the CTO/co-founder of a startup (different to the one im describing in this post) thats gone from $700k -> $2.1m ARR in the last 12 weeks.
Unrelated to that, a friend
Top Comments
u/kennyg293
Based on real claims (PII scrubbed of course) from large insurance company database made available to us. All answers were manually assessed - 1,000 at a time to make sure prompts were correc
u/kennyg293
Nah gotta try figure out a way to get to the right people to open that discussion :( but it would be awesome if someone wanted to buy it
u/SMG4231
Hi, I’m a VC in the Insurtech space and the former COO of a major carrier. Shoot me a DM and would be happy to connect with you/your friend to find a potential fit for the role.
u/kennyg293
Based on real claims (PII scrubbed of course) from large insurance company database made available to us. All answers were manually assessed - 1,000 at a time to make sure prompts were correc
u/Huge_Resolution_3627
I have some connections to insurance agencies. I would like to connect and discuss
u/es1384
You didn’t test this on your partner’s company’s database without their knowledge or sign off, right? Right? This was some OTHER “large insurance company database”?
u/Gantstar
How adoptable is it to uk market and a niche within that area
u/Gantstar
So the insurance company you got the data did they buy the solution from you
u/Better-Vanilla2651
The Insurance industry is notoriously conservative when it comes to technology (especially AI products), so it’s a bit of a grind to get these types of ideas past the decision makers. That’s
u/Efficient_Zombie_930
See Further.ai
u/Citcom
As someone is insutech who have suggested many such ideas to my company, there are a few things to keep in mind.
1 - Insurance companies have a lot of tech debt, so it's hard to allocate fun
u/danielkov
> An AI-based insurance claims assistant product that assesses claim for any policy with >99% accuracy within a matter of seconds.
> It doesn't use any of the expensive/time-consumin
u/es1384
Google does a flavor of this with the 10 in their 70/20/10. Google “googles 70-20-10 principle”. If you don’t paper the agreement make sure you keep copies or voicemails of any time senior le
u/Shichroron
You’re running a 2.1m arr business and causality taking side projects. More power to you my friend
u/kennyg293
The tech is transferable to anything document based so no problem, but in terms of UK regulations that would need to be something to read up on
u/Shichroron
You’re running a 2.1m arr business and causality taking side projects. More power to you my friend
u/kennyg293
well actually this is precisely the reason why im looking for a CEO! I dont have the expertise nor the time to act as CEO but do love making things that I see value in
u/es1384
Nice! Be careful though. Make sure it’s unambiguously documented that the employer has no ownership rights. Can’t tell u the number of times I’ve seen situations in which an FTE “had an idea”
u/kennyg293
lol we were given clearance by the correct authorities. All PII pre-scrubbed + slightly adjusted using GPT. Squeaky clean 😎
u/kennyg293
Haha fair enough, theres a big section we've written up on why this isn't a chat GPT wrapper but I can see why most would see it that way at first.
We've also thought about pretty much a
u/danielkov
Forgive me for my ignorance, but if you're not training your own models and not using an existing API... What are you doing, exactly?
> my partner is a senior claims officer
This might b
u/Gantstar
If it’s a high rate to review what is the success in terms of paying out and declining claim …what is your 99% based on and what data did you use ?
u/kennyg293
Haha fair enough, theres a big section we've written up on why this isn't a chat GPT wrapper but I can see why most would see it that way at first.
We've also thought about pretty much a
u/Aggressive-End7929
If you are interested we can work together in Saudi Arabia market as they are looking for such solutions
u/kennyg293
Oh nah, I mean we are using an LLM api but thats just one part of the entire pipeline. To reduce it down to just a chatGPT wrapper wouldn't be quite accurate imo but you could call it that i
u/Gantstar
So the insurance company you got the data did they buy the solution from you
u/danielkov
> An AI-based insurance claims assistant product that assesses claim for any policy with >99% accuracy within a matter of seconds.
> It doesn't use any of the expensive/time-consumin
u/kennyg293
Nah gotta try figure out a way to get to the right people to open that discussion :( but it would be awesome if someone wanted to buy it
u/Gantstar
Check and get back to me
u/Gantstar
If it’s a high rate to review what is the success in terms of paying out and declining claim …what is your 99% based on and what data did you use ?
u/danielkov
Forgive me for my ignorance, but if you're not training your own models and not using an existing API... What are you doing, exactly?
> my partner is a senior claims officer
This might b
u/Better-Vanilla2651
The Insurance industry is notoriously conservative when it comes to technology (especially AI products), so it’s a bit of a grind to get these types of ideas past the decision makers. That’s
u/kennyg293
well actually this is precisely the reason why im looking for a CEO! I dont have the expertise nor the time to act as CEO but do love making things that I see value in
u/kennyg293
that sounds scary...i wouldnt want it taken away :( will definitely keep this in mind!!