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SmartClaimAI

SmartClaimAI is an AI-driven solution designed to streamline and automate the refund claims process. By leveraging AI Agents, it enhances efficiency, accuracy, and customer satisfaction in claims management.

Features

  • Automated Claim Processing: Utilizes AI to assess and process claims swiftly, reducing manual intervention and processing time.
  • Image Analysis: Employs Vision Language Models (VLMs) to evaluate uploaded images for damage assessment, ensuring accurate claim evaluations.
  • Natural Language Processing (Sentiment Analysis): Analyzes customer-submitted reviews/complaints to extract relevant information pertinent to the claim.
  • Fraud Detection: Incorporates algorithms to identify and flag potentially fraudulent claims, safeguarding against losses.

Installation

  1. Clone the Repository:

    git clone https://github.com/yasho191/SmartClaimAI.git
  2. Navigate to the Project Directory:

    cd SmartClaimAI
  3. Install Dependencies:

    Ensure you To continue with the installation process for SmartClaimAI, please ensure you have the following prerequisites installed on your system:

Prerequisites

  • Python 3.10 or higher: SmartClaimAI is built using Python, so you'll need Python 3.10 or a later version installed.
  • Virtual Environment (optional but recommended): It's advisable to create a virtual environment to manage dependencies and avoid conflicts.

Installation Steps

  1. Clone the Repository:

    Open your terminal or command prompt and execute:

    git clone https://github.com/yasho191/SmartClaimAI.git
  2. Navigate to the Project Directory:

    cd SmartClaimAI
  3. Set Up a Virtual Environment (Optional but Recommended):

    Create aand activate Virtual Environment:

    python -m venv smart_claim_env
    source smart_claim_env/bin/activate
  4. Install Dependencies:

    Ensure you have pip installed, then run:

    pip install -r requirements.txt

    This command installs all necessary packages listed in the requirements.txt file.

  5. Set Up Environment Variables:

    Create a .env file in the project root directory to store environment-specific variables, such as API keys and database credentials.

    Populate the .env file with the required variables as specified in the .env.example file.

Supported Models

Currently, you can use gpt-4o, gpt-4o-mini or open-source model microsoft/Phi-3.5-vision-instruct as the vision language model for image analysis. For sentiment analysis the model used is ProsusAI/finbert which classifies sentiment as (Positive, negative and Neutral). For final summarization and processing you can use gpt-4o or gpt-4o-mini. (Open source model will be supported soon)

Usage

After installation, you can use SmartClaimAI's Gradio dashboard to experiment with some text cases. To launch the dashboard just use the following:

python main.py
  • Submit Claims: Use the application's interface to submit insurance claims with the necessary images.
  • Automated Processing: Leverage AI capabilities for image analysis, sentiment analysis, and fraud detection to process claims efficiently.

Dashboard Preview Gradio Dashboard

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AI Agent Based Refund Processing Workflow

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