Odie Pet Insurance Partners with Five Sigma’s Claims Management Platform

by | Jan 28, 2025 | Odie for Business

Odie Pet Insurance is a forward-thinking company dedicated to democratizing pet health coverage. Odie was founded in 2019 with a mission to provide dog and cat owners with flexible and affordable insurance coverage, focusing on making high-quality pet care accessible to all. Odie offers insurance policies that are designed to eliminate the financial burden associated with caring for pets when unexpected illnesses and injuries occur. Odie is a successful brand with a compelling value proposition. It serves dog and cat owners across the U.S., supporting pet owners and partners through a centralized digital platform. In 2024, Odie won Fintech Global’s Insurtech 100 award, recognizing its forward-thinking innovation.

Finding the Right Claims Management Solution

As Odie expanded its business and operations, it became clear that managing claims for a specialty line of business like pet insurance required a scalable and flexible claims management system (CMS). Pet insurance claims entail various sub-categories, like routine wellness visits, vaccinations, accidents, and illness coverage, each requiring different levels of attention and workflows. Odie needed a partner capable of delivering a platform that caters to the unique nuances of pet health claims.

Odie partnered with Five Sigma, another innovative leader in the Insurtech landscape (and recipient of the 2024 Insurtech 100 award, like Odie), committed to transforming claims management operations through AI and automation.

Five Sigma developed an AI-native claims management platform that is perfect for any specialty insurance line. Five Sigma’s SaaS platform serves insurance companies of any size, scaling easily as the business grows. With Five Sigma’s easy, no-code configuration capabilities, Odie could customize its claims workflows based on the specific pet insurance policies it offers and specific claims sub-categories, allowing the platform to accommodate different coverage types and adapt quickly to Odie’s evolving business needs.

Odie Automates for Success

Five Sigma’s advanced technology seamlessly integrated with Odie’s digital platform, supporting its mission to provide accessible, streamlined, and modern customer service. This integration allowed Odie to automate many time-consuming manual processes, like the First Notice of Loss (FNOL) population, reserve setting, and document summaries.

Odie allows policyholders to choose from various reimbursement rates, deductible amounts, and annual limits, enabling tailored coverage for pet owners. Five Sigma’s claims management platform easily calculates reserves and coverage amounts based on the pet owner’s specific policy on Odie’s digital platform. The implementation process also included quick and easy onboarding of staff members, thanks to the easy and intuitive interface of Five Sigma’s claims management platform.

Odie Reaping the Benefits and Claims a Victory in Efficiency

Since the integration of Five Sigma’s platform, Odie has seen notable improvements across its claims management operations:

  1. Reduced Cycle Times: Together with Five Sigma’s payment processing structure, Odie was able to implement an ACH payment solution that ultimately reduced reimbursement time by almost 75%. Additionally, Odie expects to see a 20% minimum decrease in claims processing time by early 2025.
  2. Configurability – Quick no-code setting on the Five Sigma platform of various claims categories and subcategories enables Odie to implement customized workflows without downtime or requirements from IT or Five Sigma.
  3. Automation: With Five Sigma’s advanced automation, Odie sets up claims at FNOL automatically. Claims are adjudicated with minimal manual input, ensuring faster resolution times and fewer errors. This allows Odie’s team to handle a larger volume of claims as the business grows without sacrificing quality and enables a focus on customer service in complex cases.
  4. Optimal communications: Five Sigma’s platform offers a centralized communication hub where all communications with policyholders (pet owners) and vendors are recorded and summarized – via email or phone. The centralized claims communication has streamlined Odie’s interactions with pet owners and veterinary professionals, simplifying decision-making and enhancing the overall customer experience.
  5. Data-Driven Insights: With access to real-time and historical claims data, along with AI-driven actionable recommendations, Odie’s claims team can make better, more informed decisions on coverage and settlement, improving claims outcomes for the company and policyholders.
  6. Operational Efficiency and Accuracy: Five Sigma’s system has built-in safeguards that ensure accurate claims processing, reduce overall loss, streamline auto-denials, and separate complex and simple claims.

Chasing Innovation: Odie and Five Sigma’s Next Steps

As two Insurtech innovators, Odie and Five Sigma seek the next technological advancement to transform pet insurance and claims management. In July 2023, Five Sigma launched Clive™, the insurance industry’s first AI Claims Adjuster. Clive helps claims teams improve productivity by AI analysis that improves decision-making and automating many more manual tasks that took significant time. Odie is currently experimenting with Clive for automatic vet invoice processing, extracting data, automatically populating fields in the claims management platform, and analyzing the implications for coverage and payouts.

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