Claimplex AI
Not a better draft — a digital claims workforce that files, chases, and collects.
A claimant-side claims operations engine for claims firms: intake, underwrite, draft, file to regulators, survive kickbacks, negotiate, and collect the fee. Unlike drafting-only tools, Claimplex actually files claims through official channels with screenshot evidence — and learns from every regulator rejection.
- AI agents
- 6
- core features
- 6
- built for
- Claims
What it does
Key features
- Case triage with limitation & SOL checks
- Claim-economics underwriter gate
- Complaint drafting + regulator pack validation
- Portal filing with screenshot evidence chains
- Kickback Killer — learns from every rejection
- Fee capture & compliance Standing Guard
The agent team
6 agents, each with one job
Each agent handles one part of the workflow and passes the work to the next. A person approves anything high-stakes.
Triage Agent
A specialist agent inside Claimplex AI, working autonomously with the rest of the team to close its part of the workflow.
Economics Underwriter
Analyzes the data to score, predict, and recommend the highest-value next move.
Document Processor
Reads and understands inbound documents, extracts the key data, and files it where it belongs.
Portal Filer
A specialist agent inside Claimplex AI, working autonomously with the rest of the team to close its part of the workflow.
Evidence Nagger
Follows up relentlessly but politely across SMS, email, and calls until the loop is closed.
Standing Guard
Watches for compliance, fraud, and policy violations, and blocks risky actions before they happen.
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