On this episode of FNO: InsureTech, Rob Beller and Lee Boyd sit down with Heather Wilson, CEO of CLARA Analytics, to explore how an “AI claims intelligence platform” is reshaping the way carriers, TPAs, and self-insureds manage complex claims across workers’ comp, auto liability, and general liability. Heather shares how Clara’s always-on models act like a claims-focused version of Waze, continuously monitoring every data point on a file and surfacing risks, leakage, and next-best actions long before a human would typically spot them.​

From predictive analytics to agentic AI
Heather traces CLARA'S evolution from early predictive analytics and machine learning in 2012 to today’s world of generative and agentic AI, where specialized “data agents” clean, map, and standardize messy legacy data and “AI agents” orchestrate 20+ models to recommend optimal paths on a claim. She explains why you no longer need armies of data quality analysts and engineers, and how agent-based automation will increasingly handle 80% of the work while adjusters and leaders focus on judgment, empathy, and strategy.​

Turning documents into intelligence, not noise
Digging into document intelligence, Heather describes CLARA'S journey using large language models to extract signals from legal bills, medical bills, and other unstructured content—overcoming early “hallucinations” through targeted training and feedback loops. She highlights how the system can spot subtle terms, limits, or codes adjusters may miss and how explainability and transparency are built into the outputs so users understand why the model is surfacing a risk or recommendation.​

Real ROI and an expanding value story
Heather details how CLARA quantifies impact, from catching sleeper claims and reducing inappropriate claim reassignments to optimizing provider networks and litigation strategies. She shares examples of carriers and self-insureds seeing 2–3% loss cost savings in the first six months and 5–10x ROI over 12 months, as AI-driven insights lead to better reserving, earlier settlements, and fewer leakage and fraud issues.​

The human role in an AI-first future
Despite rapid automation, Heather emphasizes that CLARA remains intentionally non-prescriptive: the machine does the heavy lifting, but humans still make the final calls—especially on complex, emotional claims where empathy and nuance are essential. She paints a near-term future where adjusters manage larger, more complex caseloads with AI-generated “risk notes” summarizing dormant files, while brokers and actuaries rely on their own AI agents to continuously scan portfolios, coverages, and risk signals.​

A lifelong learner at the edge of change
Rob and Lee also dig into Heather’s career journey—from linguistics and Anderson Consulting to Kaiser Permanente, Citi, AIG, and now leading an insurtech at the cutting edge of data and AI. She reflects on being an early voice for data as a strategic asset, her passion for bringing more women into tech and data science, and her concern that carriers who delay AI adoption risk failing the next generation of insurance talent and policyholders alike.​

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Listeners come away with an inside look at how AI is moving from buzzword to operational backbone in claims, what “agentic AI” really means inside a carrier, and why the winners in the next two years will be those who pair robust data foundations with human-centered decision-making