How the claim
actually moves.
AXK is programmable claims infrastructure that verifies, decides, settles and proves, across every line of insurance. One rules engine reads the evidence, makes the decision, and writes the record. It does not underwrite risk and it does not hold funds.
Five steps, one engine.
AXK sits between the claimant, the insurer, the payment rail and the regulator. Every claim, in every line of business, moves through the same five steps.
Submit
A claim is filed by the party closest to the event. A hospital files from the encounter. A driver files from the accident. A farmer is filed for automatically by the index. A property owner or an employer files against the policy. The claim carries its evidence with it.
- Provider portal
- Insurer API
- Index trigger
- Claim intake
Verify
The rules engine checks three things at once: is the policy in force and does it cover this, do the supporting documents hold up against the systems that issued them, and does the claim look like fraud. Evidence is read from the source system, not from an attachment.
- EMR
- Police reports
- Weather index
- Civil registry
- Policy register
- Fraud model
Settle
A claim that clears the rules and the fraud model is approved without a reviewer. Settlement is triggered over the rails that already exist: mobile money to a person, bank transfer to an institution. AXK does not hold the money. It instructs the payment and records the instruction.
- Mobile money rails
- Bank rails
- Settlement ledger
Route
A claim that is incomplete, disputed or high-risk is not rejected. It is routed to a human with the verification already done, the missing evidence named, and the rule that stopped it attached. The reviewer decides the hard part. The engine has done the rest.
- Review queue
- Exception rules
- Case notes
Prove
Every decision writes an append-only record: what was claimed, what evidence was read, which rule fired, who approved it, what settled and when. The insurer sees its own book. The regulator sees the process. Neither has to ask the other for a spreadsheet.
- Audit log
- Insurer dashboard
- Regulator view
One rules engine, every line
Cover, exclusions, limits, waiting periods and thresholds are written as rules against a claim schema. A motor rule and a health rule are the same kind of object. Adding a line of business means writing rules and connecting evidence, not building a second system.
What it evaluates- Policy validity
- Benefit limits
- Exclusions
- Document completeness
- Fraud signals
Fraud scoring before review
Every claim carries a score built from billing patterns, duplicates, provider and claimant history, and outliers against the peer set. The score decides who a human looks at. It does not decide the claim.
Evidence read from source
A claim is checked against the system that issued the evidence: the medical record, the police report, the weather index, the civil registry. A document is a pointer to a fact, not the fact itself.
Electronic medical records
The clinical encounter a hospital already recorded — diagnosis, procedure, prescription.
Police reports
Accident and incident records behind a motor or property claim.
Weather and IoT indices
Rainfall, temperature and soil-moisture readings that trigger agriculture cover.
Civil registry
Death records and identity matching behind a life claim and its named beneficiary.
Insurer policy and benefit tables
Cover, limits, exclusions and waiting periods, exactly as the insurer wrote them.
Mobile money and bank rails
Where an approved claim settles. AXK instructs the payment; it holds no funds.
A record both sides can read.
Every decision writes an append-only record: what was claimed, what evidence was read, which rule fired, who approved it, what settled and when. The insurer sees its own book. The regulator sees the process. Neither has to ask the other for a spreadsheet.
An audit trail both sides can read
Decisions are append-only and attributable. The insurer can reconstruct any payout. The regulator can inspect the process without being handed a report the insurer wrote about itself.
- Audit log
- Insurer dashboard
- Regulator view
Privacy-first by construction
Claim decisions need the facts of a claim, not a copy of a patient file. Evidence is verified against the source and the decision records what was checked, not the underlying record. Access is scoped to the party that needs it.
Answered honestly.
Several of these answers are no. A procurement team trusts a site that tells them what it does not do.
Does AXK underwrite risk?
No. AXK is infrastructure. The insurer writes the policy, prices it and carries the risk. AXK verifies the claim against that policy, settles it over a payment rail, and records the decision. We hold no risk on our balance sheet.
Is this a health-insurance product?
No. Health is one of five lines we run: health, motor, agriculture, property and liability, and life. The same rules engine adjudicates all of them. A new line means new rules and new evidence sources, not a second system.
How do payouts reach people?
Over the rails that already exist. Mobile money to a person, bank transfer to an institution. AXK does not hold funds, run a wallet or float money. It instructs settlement against an approved claim and reconciles the payment back to it.
What about data privacy?
A claim decision needs the facts of the claim, not a copy of the patient file. Evidence is verified against the system that issued it, and the audit record holds what was checked and which rule fired, not the underlying record. Access is scoped to the party that needs it.
If everything is automated, who reviews the hard claims?
Your people do. A claim that is incomplete, disputed or high-risk does not settle automatically and it does not get rejected automatically either. It routes to a human with the verification already done, the missing evidence named, and the rule that stopped it attached. Automation decides which claims are easy, not which claims are true.
What does AXK need from an insurer to start?
The policy and cover data, the rules the insurer already applies by hand, and a settlement account. Evidence sources are connected next: the medical record system, the police report feed, the weather index or the civil registry, depending on the line.
Do hospitals have to change how they work?
They file the claim from the encounter they already record. AXK reads the medical record rather than asking anyone to re-key it into a portal. A system that requires every institution to migrate first never starts.
How does a regulator see what happened?
Every decision writes an append-only record: what was claimed, what evidence was read, which rule fired, who approved it, what settled and when. The regulator inspects the process directly instead of receiving a report the insurer wrote about itself.
See how it adjudicates your claims.
Bring your policy rules and one line of business. We will show you the same engine running against them.