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TPA Processing
Make faster, more consistent decisions with AI-powered validation
Automate eligibility checks and surface decision signals so underwriters focus on cases that need human judgment
The problem
Fraud, errors, and manual claim processing slow decisionsFraud, manual reviews, and inconsistent data drive significant premium losses across claims.
Insurance fraud costs businesses and consumers $300B+ per year. Manual claim processing error rates are 4.3%, compared to 0.8% for automated processing. 12% of all premiums are lost on fraud.
Our solutionAutomate validation, flag risk, and guide decisions
Mahalo OpX automates policy checks, provides AI decision support, and flags high-risk claims to help adjusters.
Automated eligibility validation against purchase date, coverage period, and policy terms. Claim Confidence Score with contributing signals and risk flags. Audit-ready decision records in a single system of record. -
Claims Management
Run the full claim cycle in one system of record
Triage, review and resolve claims in a shared workspace where teams collaborate and every decision stays tied to the claim record
The problemClaims lack details and are processed across systems
Claims are submitted with missing details and processed across different tools leading to delays and inconsistency.
The average claim takes 2 to 4 weeks to fully process and resolve. Warranty requests cost OEMs $15+ per ticket and take about 30 minutes to process. Customers interact 8+ times for a single claim.
Our solutionCapture, validate, and process claims in one system
Mahalo OpX keeps all claims work in one place with a central inbox, collaboration tools, and timeline tracking.
Centralized claims inbox with filtering, assignment, routing built for collaboration. Two-way connection with CX for status and customer updates. Timeline view that logs evidence, validation checks, decisions, and outcomes. -
Dealer Management
Coordinate service across your dealer network
Eliminate duplicate work and errors by automating claims submission from service intake to approval
The problem
Manual workflows reduce dealer efficiency and marginPaper-based workflows and manual entry slow claims, increase errors, and lead to lost warranty margin for dealers.
100+ million repair orders are written on paper and need to be entered into a system manually. 15% of warranty gross profit is lost due to manual processing complexities. Dealers who don’t automate claims processing spend up to $175k more per year.
Our solutionCapture once and automate compliant submissions
Mahalo captures data at intake, validates requirements in real time, and eliminates re-entry.
Facilitated claims submission with real-time validation against requirements and terms. Smart compliance checks that catch missing documentation, incomplete 3C's, and policy violations. Direct integration with TPA systems eliminates manual data re-entry across platforms. -
Post-Purchase Troubleshooting
Resolve issues before they become claims
Guide customers to answers with AI-powered troubleshooting that reduces support tickets and prevents unnecessary claims
The problem
Most claims start as simple questionsWarranty volume often stems from fixable issues, missing product knowledge, and customers repeating themselves.
89% of “warranty claims” stem from product confusion and fixable issues. 91% of customers say they’d use a knowledge base if it met their needs. 60% of customers get frustrated when they repeat the same issue to multiple people.
Our solutionEscalate to a claim only when needed
Mahalo CX delivers branded self-service with AI troubleshooting and structured claim capture.
AI-powered troubleshooting trained on your product docs and support history Guided workflows that capture symptoms, product details, and troubleshooting steps attempted Seamless escalation to claim submission with full context already captured -
Pre-Purchase Support
Answer product questions before the sale
Give prospective customers instant, accurate answers with AI trained on your product catalog and specifications
The problem
Rising support volume slows pre-purchase decisionsIncreasing support volume and poor early experiences slow decisions, reduce conversions, and create risk for churn.
Most customer care leaders expect support volumes to increase by 20% over the next 1-2 years. Website visitors who chat are 2.8x more likely to convert. Poor early support experiences increase churn risk and brand damage.
Our solutionDeliver instant answers that drive confident purchases
Mahalo provides AI-powered, context-aware product answers and guided flows that help prospects decide faster.
AI-powered product Q&A grounded in specs, manuals, and compatibility data. Guided product comparison and recommendation flows. Lead capture and handoff to sales when human assistance is required.
