Claimable, an AI-powered startup launched in October 2024, is tackling one of American healthcare’s most persistent problems: insurance claim denials. Founded by Warris Bokhari, a former ICU doctor and insurance industry veteran, the company leverages artificial intelligence to help patients appeal denied medical claims with an impressive 85% success rate.
Bokhari’s journey to creating Claimable began with his experience working at insurance company Anthem and witnessing the stark contrast between healthcare systems in the UK and US. Raised in the UK with two disabled parents who never faced bankruptcy due to medical expenses, Bokhari was struck by how American patients face uncertainty about receiving necessary medical care. His time as an ICU doctor in the UK, where treatment was “never denied,” further highlighted the systemic issues plaguing US healthcare.
The timing of Claimable’s launch coincides with renewed scrutiny of the insurance industry following the fatal shooting of UnitedHealthcare CEO Brian Thompson. While condemning violence, Bokhari emphasized that “the productive solution is appealing” rather than resorting to extreme measures. The incident has sparked widespread online discussions revealing deep frustrations with insurance practices.
Claim denial rates have been climbing for over a decade. According to health policy research firm KFF, 17% of in-network claims by HealthCare.gov insurers were denied in 2021. While 41% of appealed claims were overturned, less than 1% of consumers actually went through the appeals process—a gap Claimable aims to bridge.
The platform works by having patients describe their condition and the impact of treatment denial. Claimable’s AI then analyzes millions of data points from clinical research, appeal precedents, policy details, and individual medical histories to generate customized appeals within minutes. Most appeals cost patients $39.95 plus shipping.
Currently, Claimable supports appeals for over 70 FDA-approved treatments for autoimmune and migraine conditions. The company has filed hundreds of appeals and sends copies not only to insurance companies but also to every relevant regulator. Bokhari believes regulators don’t realize how frequently these “private tragedies happen every day in American life.”
Backed by Walkabout Ventures, Humanrace Capital, and others through a seed round closed in March, Claimable is part of Nvidia’s startup program and operates with approximately 11 employees.
Key Quotes
It’s no wonder why people give up. If you’re a rational person, you would say this model was not fit for purpose.
Claimable CEO Warris Bokhari describing the broken insurance appeals process that inspired him to create an AI solution. This quote captures the fundamental problem his startup addresses—a system so complex and frustrating that rational people abandon legitimate claims.
That is not the productive solution. The productive solution is appealing.
Bokhari’s response to the violence surrounding the UnitedHealthcare CEO shooting, positioning his AI-powered appeals platform as a constructive alternative to frustration with the insurance industry. This statement positions technology as a path forward during heightened tensions.
Regulators probably assume that these denial cases are occasional. They make big headlines, but they don’t know that these very private tragedies happen every day in American life.
Bokhari explaining why Claimable sends appeal copies to regulators, not just insurers. This reveals a strategic approach to using AI not just for individual cases but to create systemic visibility that could drive policy changes.
Our Take
Claimable exemplifies a crucial trend in AI development: using artificial intelligence to address power imbalances rather than simply optimizing existing systems. While much AI healthcare discussion focuses on diagnostic tools or administrative efficiency for providers, Claimable puts AI directly in patients’ hands as an advocacy tool. The 85% success rate suggests many denials lack legitimate medical justification—a reality that AI’s ability to rapidly analyze precedents and policies can expose. The company’s participation in Nvidia’s startup program also signals how major tech players are supporting healthcare AI applications beyond traditional medical imaging or drug discovery. Most intriguingly, by systematically notifying regulators, Claimable is using AI-generated data to potentially force systemic reform—transforming individual appeals into collective evidence of industry practices. This represents a sophisticated understanding of how AI can create change beyond individual transactions.
Why This Matters
Claimable represents a significant development in applying AI technology to solve real-world healthcare challenges. With claim denial rates rising and less than 1% of patients pursuing appeals despite a 41% overturn rate, there’s a massive gap between patient rights and practical access to justice. The startup’s 85% success rate demonstrates AI’s potential to democratize access to complex administrative processes that typically require expensive legal expertise.
The story also highlights growing tensions in the healthcare-AI intersection. While insurance companies face criticism for using algorithms in claim decisions, startups like Claimable are using AI to level the playing field for patients. This creates an interesting dynamic where AI becomes both the problem and the solution.
Moreover, Claimable’s approach of sending appeals to regulators could create systemic change by making the scale of claim denials visible to oversight bodies. As AI tools become more accessible for patient advocacy, we may see a fundamental shift in the power dynamics between insurers and consumers, potentially forcing industry-wide reforms in how claims are processed and denied.
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Source: https://www.businessinsider.com/ai-claim-startup-ceo-appeals-productive-for-pushing-change-2024-12