For P&C carriers
Decision Governance for Claims
Optimize the claims process — govern every file at decision time, for full-book visibility rather than a sample.
Reconstruct any decision — the rule, the authority, the evidence, and the human reasoning, preserved with the file.
AudRI governs every file at decision time — and proves why.
The problem
Two gaps persist in claims operations:
the Money Gap and the Liability Gap.
AI is widening both.
Traditional sampling gives carriers visibility into a fraction of the claims book. Across the rest, financial exposure and decision rationale are harder to see — and AI-driven processing is accelerating the pace.
Full visibility across the book — not a sample.
Manual QA typically reviews 3–5% of files after they close; AudRI evaluates 100%. Limited sampling can leave leakage, fraud, and reserve errors outside the reviewed population — across the other ~95% of the book.
Traceable rationale, across every system.
Most carriers already have controls in place. But as AI accelerates decisions, the rationale and authority behind a call can fragment across systems and workflows — and become hard to reconstruct when it's later questioned. AudRI keeps it auditable, traceable, and defensible.
What AudRI does
It governs the decision — not just whether a step was completed.
Traditional QA confirms a process step was followed. AudRI governs the decision itself: whether the right amount went to the right party, for a defensible reason, under the appropriate authority — and it preserves that reasoning with the file.
Systems of record store the claim. Dashboards report on it after the fact. AudRI governs the decision at the moment it's made.
Governed decision
CLAIM WC-2026-04821 · reserve set
$48,500 — approved to claimant
Every element — rule, authority, evidence, and human reasoning — stays part of the durable decision record.
How it works
Extract. Execute. Explain.
Deterministic execution where it matters, with human oversight throughout.
Extract
Your rules, made executable — pulled from your SOPs, policy contracts, and regulatory bulletins, each tied to the clause, page, and authority it came from.
Execute
Every file is evaluated against the current rule set at decision time — 100% coverage, at the moment the decision is made.
Explain
The reasoning and evidence are preserved with the decision — the rule, the named authority, and the supporting record.
Reconstruction & oversight
When a decision is questioned, reconstruct exactly why.
A complete, decision-level reconstruction — the rule, the authority, the evidence, and the human reasoning behind every call.
Overrides become part of the record.
An adjuster can override any AudRI call — humans retain decision authority. The override, and the rationale behind it, become part of the durable decision record rather than living in memory.
An independent governance layer.
The system that executes a decision shouldn't be the only system that attests to it. AudRI sits independently across the claim file and decision process — and that independence and cross-file visibility strengthen auditability, regulatory defensibility, and litigation readiness.
Business value
Outcomes, not licensing structure.
Dollars protected, decisions governed, and measurable movement toward best-in-class claims performance — extending the reach of the QA work your team already performs.
Quality, extended
The quality work you already do — across every file.
Claims-quality management, SOP adherence, coaching, and reporting are natural outcomes of governing every decision — extending your team's reach across the entire claims book, not replacing the work they do.
Get started
See decision governance on your own claims.
Govern every file at decision time, reconstruct any decision, and extend your team's quality reach across the entire book.
contact@getaudri.com · getaudri.com