Medical Record Review Software for Reserve Decisions on California Claims

California claims professionals need a supportable reserve early, sometimes while medical records are still arriving. OraClaim is defense-focused claims intelligence software that claims teams handling California matters can use to organize the records they already have. It synthesizes treatment, injury and wage-loss details into summaries. Those summaries can support earlier, better-documented reserve decisions and alignment with outside counsel.

Claims professional reviewing AI-organized medical records

Capabilities for Claims Teams

The OraClaim capabilities most relevant when medical records drive reserve and exposure decisions.

Medical Chronologies

Converts uploaded records into a dated chronology of providers, diagnoses, treatment and gaps for adjuster and counsel review.

Exposure Drivers

Surfaces exposure drivers, missing information and contradictions across records, statements and reports.

Litigation Timelines

Lines up treatment, injury details and case events so claims and defense teams share one sequence of facts.

Case Evaluations

Drafts evaluations covering liability, causation and damages issues for the claims professional to review and finalize.

Reserve-Support Summaries

Synthesizes medical data, wage-loss information and treatment patterns into summaries that support reserve decisions.

Shared File With Counsel

Gives adjusters and outside counsel one organized claim file, so both start from the same facts.

Where OraClaim Fits

From Medical Records to a Reserve-Ready View

Reserve work on a medical-heavy claim means reading treatment records, weighing future care and wage loss, and documenting the basis for authority. The workflow starts with records your team has already collected. OraClaim classifies them, structures treatment and wage-loss details, and flags causation issues, timeline gaps and conflicting statements. It then drafts summaries and case evaluations. The adjuster, claims manager or defense attorney reviews that work product and makes the reserve, liability and settlement call.

AI medical chronology and claim review workspace
Why OraClaim

Why OraClaim for Reserve-Focused Review

Claims intelligence built for the defense side, where reserve accuracy and outside counsel alignment matter.

Built for Carriers and Self-Insureds

Designed for carriers, self-insured organizations and their defense counsel, not plaintiff firms.

Reserve Calls Stay With You

Summaries support the reserve discussion. The adjuster or claims manager sets the reserve and owns the call.

Wage Loss in the Same View

Wage-loss details sit beside the medical picture, so reserve reviews do not juggle separate stacks.

Capacity Without New Hires

OraClaim says it helps teams handle more cases without adding headcount.

Meet the OraClaim Founders

Built by claims, risk, and data security leaders.

Portrait of Mark Tepper, Co-founder and CEO of OraClaim

Mark Tepper

Co-founder & CEO

Mark Tepper is the Co-founder and CEO of OraClaim, an AI-powered platform purpose-built for defense lawyers and claims professionals. Drawing on his firsthand experience litigating claims and managing risk for enterprise companies and insurers, Mark identified a critical gap in the defense ecosystem: overwhelming claim volumes compounded by manual processes and unstructured data. This insight drove him to co-found OraClaim with the mission of leveling the playing field against plaintiff firms leveraging technology. Mark brings deep legal and risk management expertise to the company, guiding its strategic vision and ensuring the platform delivers real, measurable value to defense teams across the United States. His commitment to improving the lives of those who manage and defend claims is at the heart of everything OraClaim builds.

Portrait of Andy Anderson, Co-founder and COO at OraClaim

Andy Anderson

Co-founder & COO

Andy Anderson is the Co-founder and COO at OraClaim, bringing extensive expertise in insurance risk analysis and high-exposure claims management. Having spent his career analyzing risk for insurers and managing complex, high-stakes claims, Andy developed a deep understanding of the inefficiencies that put defense teams at a disadvantage relative to plaintiff firms embracing technology. This experience inspired him to co-found OraClaim alongside Mark Tepper, with the shared goal of transforming how defense lawyers and claims professionals work. As COO, Andy is dedicated to connecting defense organizations across the United States with OraClaim's AI-driven platform, helping them scale capacity, reduce costs, and achieve better outcomes on every claim without sacrificing quality.

Portrait of Ali Khan, Co-founder and Head of Engineering at OraClaim

Ali Khan

Co-founder & Head of Engineering

Ali Khan is the Co-founder and Head of Engineering at OraClaim, a seasoned data security engineering leader who plays a central role in building and safeguarding the platform's technical foundation. Recognized for his expertise in secure system architecture, Ali was brought on by co-founders Mark Tepper and Andy Anderson specifically to ensure that OraClaim's AI platform meets the highest standards of encryption, authentication, and data protection. His work underpins the trust that defense lawyers, insurance carriers, and claims organizations place in the platform every day. Ali is committed to delivering a robust, secure, and scalable solution that integrates seamlessly with existing practice management and document management systems, empowering defense teams to work smarter without compromising on security or accuracy.

Frequently Asked Questions

Is OraClaim a California medical record review provider?

No. OraClaim is software claims teams can use to document the medical basis for reserves, not a review provider. It does not retrieve records, perform nurse or physician review, or perform California workers' compensation UR, IMR or QME work. California law stays with your team and counsel.

Can a claims supervisor review the basis for an adjuster's reserve?

How can Proposition 51 affect exposure on a California claim?

What is Proposition 213, and when does it matter?

How can a section 998 offer affect a California file's exposure?

Evaluating OraClaim for Your Claims Team?

See how medical records become summaries your adjusters and outside counsel can work from.

Investors

Backed by

MGV logo

MGV

Maschmeyer Group Ventures (MGV) is a SaaS-focused venture fund with a history of investing in insurtech startups.

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Forum Ventures

Forum Ventures is an accelerator with a history of investing in technology for the insurance and legal sectors.

Newfund Capital logo

Newfund Capital

Newfund Capital is an early-stage VC firm based in Silicon Valley and Paris that finances seed-stage startups.

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Meridian

Meridian Ventures champions visionary founders, investing mainly at the pre-seed and seed stages.

Roo Capital logo

Roo Capital

Roo Capital backs companies in applied AI, vertical software, healthcare and cybersecurity, pairing capital with talent and commercial support.

See How OraClaim Documents a Reserve's Medical Basis

Book a demo to see how OraClaim turns a medical record set into summaries that support reserve, exposure and litigation decisions.

Contact Us Today

Prefer to talk? Call us at (650) 550-2920. You can also send us a quick email at legal@oraclaim.com.