From Black Box
to Glass Box.
AI-powered claims management for California Workers' Compensation examiners. Save time, stay compliant, and train continuously — without ever crossing into legal advice.
The industry problem we solve
Three value streams. One platform.
AdjudiCLAIMS addresses your productivity problem, your compliance problem, and your training problem simultaneously.
Productivity
Saved per examiner per week through AI-assisted document review, auto-populated claim fields, and instant benefit calculations.
Compliance
Regulatory deadline compliance. Color-coded urgency tracking for every statutory deadline across your entire portfolio.
Training
The product IS the training program. Every statutory deadline cited. Every regulation explained. Every decision point teaches the why.
Everything a claims examiner needs.
Document Pipeline
Upload claim files — PDF, DOCX, images. AI automatically runs OCR, classifies by type (12 categories, 150+ subtypes), extracts key fields, and indexes for search.
Google Document AI + ClaudeRegulatory Deadline Dashboard
Every claim auto-generates its full statutory deadline set with the consequence of each miss — 1-day, 14-day, 15-day, 20-day, and 40-day milestones tracked in real time.
GREEN Zone · Factual trackingBenefit Calculator
Statutory TD rate (LC 4653: 2/3 AWE), TD payment schedules with 14-day cycles (LC 4650), automatic late-payment penalty detection, death benefits (LC 4700–4706).
GREEN Zone · Arithmetic onlyAI Chat — UPL-Filtered
"What WPI did the QME assign?" Factual answers over claim documents with citations. Legal questions are blocked and redirected to defense counsel automatically.
3-Stage UPL EnforcementInvestigation Checklist
10-item checklist auto-generated per claim: three-point contact, recorded statement, employer report, medical records, DWC-1, index bureau check, AWE verification.
CCR § 10109 CompliantEducation System
86 foundational terms, 57 always-present regulatory education entries, 4 mandatory training modules, 20 step-by-step decision workflows. Quarterly refreshers.
10 CCR § 2695.6 AlignedThe product is the training program.
Most claims software automates tasks and leaves examiners in the dark about why. AdjudiCLAIMS does the opposite. Every deadline is cited. Every regulation is explained. Every AI output shows its work.
The Glass Box philosophy: the AI shows you what it found, where it found it, and what the law says about it. No black boxes. No unexplained outputs. No guessing.
AI that knows where the line is.
Under Cal. Bus. & Prof. Code § 6125, only licensed attorneys may practice law. Claims examiners are not attorneys. AdjudiCLAIMS enforces this boundary automatically — every query, every response, every time.
Factual Data & Calculations
Medical record summaries, WPI extractions, benefit calculations, deadline tracking, document classification, claim chronologies.
Statistical & Legal-Adjacent
Comparable claims data, medical inconsistency flags, litigation indicators — presented as data only, with a mandatory disclaimer.
Legal Analysis & Advice
Coverage opinions, settlement recommendations, case law interpretation, liability determinations, outcome predictions — blocked immediately.
Ready to see it in action?
Schedule a demo for your claims team. We'll walk through a live claim — document upload through compliance dashboard.