The Oasis Platform

The operating system
for insurance.

Four interconnected intelligence systems — claims processing, fraud detection, underwriting automation, and partner distribution — unified in a single platform. Not tools for insurance people. The intelligence that does insurance work.

Claims Intelligence

Six agents. One pipeline.
Under sixty seconds.

Not a dashboard for adjusters — the adjuster itself. A 6-agent pipeline that takes a claim from raw documents to a fully adjudicated decision, with complete audit trail and policy citations.

01

Document Extraction

OCR and structured data extraction from medical bills, receipts, lab reports, discharge summaries. Sub-field bounding boxes for audit trail. Thai, Vietnamese, Chinese, English.

02

Classification

Automatic claim type classification — inpatient, outpatient, dental, maternity, accident. Document type identification and routing to specialized agents.

03

Medical Necessity

Clinical pathway validation against 60K+ medical reference records. Diagnosis-treatment alignment. Length-of-stay benchmarking. Drug appropriateness checking.

04

Benefit Assessment

Policy-level benefit calculation with precision — sublimits, deductibles, co-pays, waiting periods, exclusions. Every number traceable to policy language.

05

FWA Screening

Six-factor fraud analysis runs in parallel. Timing patterns, clinical inconsistencies, billing anomalies, provider risk, document authenticity, policy exploitation.

06

Adjudication

Autonomous decision: auto-approve (Tier 1), flag for review (Tier 2), or escalate (Tier 3). Full audit trail with policy citations. Human-in-the-loop for judgment calls.

Processing Timeline

Extract
Classify
Assess
Screen
Decide
0s~40-60s total

Fraud, Waste & Abuse

Evidence-based detection.
Zero hallucination.

Every flag is backed by data from the claim itself. We'd rather miss a flag than fabricate one. Six-factor analysis, maximum 8 flags per claim — quality over quantity.

01

Timing Analysis

Policy-to-claim gaps, frequency patterns, amount escalation, holiday/weekend clusters

02

Clinical Validation

Diagnosis-treatment mismatches, unnecessary items, contradictions between documents

03

Billing Forensics

Duplicate billing, upcoding, unbundling, extreme overpricing vs market benchmarks

04

Provider Intelligence

Concentration risk, location mismatch, unusual referral patterns, network collusion

05

Document Forensics

Missing documents, inconsistent dates, patient discrepancies, image manipulation detection

06

Policy Exploitation

Coverage change timing, benefit maximization patterns, policy stacking indicators

The Zero-Hallucination Guarantee

Our FWA agents are architecturally constrained to only flag what they can evidence. Every flag must cite specific data from the claim — dates, amounts, codes, documents. If the evidence isn't in the data, the flag doesn't exist. This isn't a feature — it's the foundation.

Underwriting Engine

Risk assessment at
the speed of data.

Transform underwriting from weeks to minutes. Automated risk evaluation, dynamic pricing, and application processing with actuarial precision.

Application Processing

Automated intake, data validation, and enrichment. Missing information detection and proactive requests.

  • Multi-format application ingestion
  • Automatic data validation
  • Missing info detection
  • Medical history extraction

Risk Assessment

Multi-factor risk scoring against underwriting guidelines, medical history, and actuarial tables.

  • Automated risk scoring
  • Pre-existing condition analysis
  • Lifestyle factor evaluation
  • Claims history correlation

Pricing & Issuance

Dynamic pricing engines that calculate premiums in real-time based on risk profiles and market conditions.

  • Dynamic premium calculation
  • Multi-product pricing
  • Automated policy issuance
  • Renewal optimization

Open Integration

OpenAPI. SDKs. MCP.
Your way in.

Full OpenAPI spec, native SDKs, and MCP server for AI agent interoperability. Integrate Papaya into any workflow, any stack, any AI agent.

OpenAPI

Full 3.1 spec — generate clients in any language

MCP

AI agent protocol — connect any agent to Papaya

Node.js SDK

Native TypeScript client

React SDK

Drop-in UI components

Webhooks

Real-time event notifications

integration.ts
// OpenAPI — generate a client in any language
const client = createClient('https://api.papaya.asia/v1');

// Submit a claim
const result = await client.claims.submit({
  documents: [invoice, receipt],
  policyId: 'POL-2026-001'
});

// MCP — let AI agents use Papaya
const server = createMCPServer({
  tools: ['submit_claim', 'check_status', 'get_benefits']
});

See it process a real claim.

We'll run your documents through the pipeline. Live. In under a minute.