Insurance claims examiners often have hundreds of pending case files from claimants filing for disability or worker’s compensation. These claims can vary from a sprained ankle to a medical condition that could sideline that worker for the rest of their career.
New York-based EvolutionIQ announced Tuesday it raised $7 million for its insurance software that uses machine learning and natural language processing to understand bodily injuries and identify how a claimant could return to work given their injuries.
EvolutionIQ’s claims guidance software can identify worker’s compensation claims where the claimant will likely return to work in a week and disability claims where the claimant is unlikely to return at all. The software then prioritizes cases where the examiner can have the greatest impact by putting a claimant on the path back to work, saving insurance companies money and allowing claimants to increase their wages.
EvolutionIQ co-founder and CEO Tomas Vykruta told Built In about one case in which a nurse who lost her finger dexterity was matched with a new career as a telehealth nurse, allowing her to earn more money.
“There are thousands of jobs in the national economy, and each job has hundreds of skills and abilities that are required to do it, with a lot of overlap,” Vykruta said. “Mapping these abilities and medical disabilities to the job market is a very complex problem.”
The software also acts as a co-pilot for claims examiners, recommending actions that would lead to the best outcome.
“We tell them that if they can execute on these steps over the next few months, they can get this person back to work instead of having to pay for their benefit for the next 30 years,” Vykruta said.
EvolutionIQ customers have seen a 35 percent increase in sick or injured people returning to work, according to the company. On average, claimants return to work about 3 ½ months sooner when using this software, according to the company.
EvolutionIQ’s Series B financing announcement comes one year after the company secured a $21 million Series A raise. The recent funding, which brings the company’s total capital raised to $33.1 million, will help EvolutionIQ develop new artificial intelligence-powered modules, as well as its own generative pre-trained transformer, or GPT, models designed for industry-specific use cases.
Vykruta, who previously worked as a machine learning engineer at Google, co-founded EvolutionIQ in 2019 with COO Michael Saltzman. EvolutionIQ has more than doubled its workforce over the past year, growing its team to more than 100 employees, according to the company. Roughly half of those employees work out of EvolutionIQ’s office in the Flatiron District.
Having tripled its revenue every year for the past three years, Vykruta said EvolutionIQ did not need to raise funds. He said he limited the size of this Series B round so employees and existing investors could retain more equity in the company.
The funding round was led by Brewer Lane Ventures, which was founded by John Kim, the former president of New York Life Insurance Company. The round was joined by Principal Financial Group, which is an EvolutionIQ customer.
“I continue to be impressed by the dramatic ROI that EvolutionIQ consistently delivers to every customer that adopts its software,” Kim said in a statement. “Claims is now the largest domain of value creation in the sector. The industry is at an inflection point and claims guidance software will be an absolute necessity for all insurance organizations across all major product lines in the next 10 years.”
