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Eastern Alliance Adopts CLARA Analytics AI Platform to Improve Workers’ Compensation Claims Management

CIO Review

SUNNYVALE, Calif. & LANCASTER, Pa.---Eastern Alliance Insurance Group (“Eastern Alliance”), a wholly-owned subsidiary of ProAssurance Corporation, has selected the CLARAty.ai platform developed by CLARA Analytics (“CLARA”), a leading provider of artificial intelligence (AI) technology for insurance claims optimization, to enhance medical outcomes for injured workers, improve reserve accuracy, and lighten administrative burdens for claims professionals.

CLARA’s claims intelligence platform integrates the company’s proven predictive analytics with advanced generative AI (GenAI) capabilities to offer a comprehensive claims management solution. The AI models analyze a wide range of data sources, including claims data, claim notes, medical records, and legal documents. This analysis enables the system to provide claims professionals with actionable recommendations for optimal next steps and proactive cost containment strategies, helping to prevent claim escalation.

Eastern Alliance is set to leverage CLARA’s comprehensive platform to address the challenge of escalating medical costs. Their strategy involves implementing a suite of CLARA’s key solutions: CLARA Optics for medical document intelligence, CLARA Treatment to direct care to the best-performing medical providers, and CLARA Triage to help focus on high-severity claims early in the claims’ life cycle.

“CLARA's capability to deliver ROI through their AI platform truly distinguished them from the competition,” stated Kevin Shook, President at Eastern Alliance. “We foresee considerable operational efficiencies and loss reductions that will create substantial value and reduce the manual workload for our claims professionals. Ultimately, this can result in savings for us and our insureds and help injured workers return to wellness and productivity faster. That potential makes this partnership a win-win for everyone involved.”

CLARA’s award-winning AI platform can analyze both structured and unstructured data, performing contextual analysis using natural language processing (NLP) and large language models (LLMs) tuned specifically for insurance claims. The generated insights help claims professionals make sound data-driven decisions. CLARA’s customers consistently achieve remarkable ROI, with most exceeding 500%.

“We are honored that Eastern Alliance has chosen CLARA as their preferred claims intelligence platform,” said Heather H. Wilson, CEO of CLARA Analytics. “This partnership aligns perfectly with our mission to revolutionize claims management. We look forward to supporting Eastern Alliance in their commitment to excellence, helping them deliver superior care to injured workers, streamline operations for their claims team, and ultimately achieve better outcomes for all stakeholders involved in the claims process.”

Workers’ compensation claims often involve extensive documentation, including hundreds of pages of medical records and other legal documents, sometimes spanning months or even years. CLARA Optics uses predictive AI, GenAI and LLMs to automate medical records transcription, extract meaningful details, and deliver actionable insights to claims management personnel. Optics eliminates time-consuming document review, and the AI-generated case summaries lead to faster case resolution, lower workloads, and better outcomes for injured workers and their employers.

CLARA Treatment leverages a vast, nationwide contributory database comprising millions of workers’ compensation claims to deliver data-driven insights on medical provider performance. CLARA Triage, using the same proprietary database, helps claims professionals to promptly identify high-risk casualty claims and flag them for proactive resolution. They are given decision support and guidance when setting reserves, leading to more accurate reserving. Injured workers get the level of service they need for the severity of the injury, and Eastern Alliance’s claims professionals can focus on the claims that matter most.

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