INSURERS & PAYERS

Orchestrating Claims & Care for High-Performance Networks.

Claims, orchestrated.

Reduce loss ratios across Auto, Workers' Comp, and Group Benefits. We bridge the gap between claims administration and clinical reality to drive faster resolution.
Business team meeting with documents, tablets, and digital icons representing checklists, charts, and quality assurance overlaid.
Traditional claims systems excel at adjudication but fail at recovery. Fragmented care leads to rising loss ratios, prolonged duration of claims, and poor member experiences.

Arthur Health empowers you to take control. We combine our CareNexus intelligence platform with industry-specific clinical logic to standardize pathways, automate workflows, and deliver measurable outcomes across your portfolio.
Built for Coordination
Designed for Outcomes
Security & Interoperability by Design
TAILORED SOLUTIONS FOR YOUR SECTOR

Purpose-Built for Complex Claims Environments.

Claims logic varies by line of business. We deliver specialized orchestration suites configured with the unique regulatory frameworks, fee schedules, and recovery pathways needed for Workers' Compensation, Auto Insurance, and Group Benefits.
Shield emblem featuring a silhouette of a person wearing a hard hat with connected nodes symbolizing coordination or network.
Workers’ Compensation & Safety Boards
Accelerate safe return-to-work for complex injury claims. Automate WSIB/WCB forms, standardize Programs of Care, and track functional outcomes.
Improve RTW rates & lower duration.
Blue icon of a car with a medical cross location marker above it inside a shield outline.
Auto Insurance Recovery
Manage collision recovery with care-first models. Integrate with HCAI, streamline MIG/minor injury pathways, and optimize provider networks.
Reduce cycle time & litigation risk.
Complex & Catastrophic Case Management
Transform high-risk claims from reactive handling to proactive recovery. Identify severity early, steer into specialized pathways, and optimize total case spend.
Reduce total claim duration through specialized care.
Icon of two people with arrows indicating communication, one person has a speech bubble with a checkmark.
Care Model Design & Advisory
Not ready for a full platform rollout? Partner with us to co-design future-ready care programs, develop value-based payment models, and define provider performance metrics.
De-risk strategy & accelerate transformation.
Person in a suit using a digital tablet with healthcare icons and a world map overlay on a blue blurred background.
THE ARTHUR HEALTH ADVANTAGE

The Intelligence Engine for Claims

How CareNexus transforms your operations:
Real-Time Visibility: See clinical outcomes alongside claims data. No more waiting for lagging indicators.
Automated Compliance: Built-in logic for HCAI, WSIB, and other regulatory frameworks ensures every claim is compliant.
Network Management: Tools to onboard, monitor, and scorecard your preferred provider networks (PPNs).
Fraud & Waste Detection: AI-driven patterns identify anomalies and outliers early in the claims lifecycle.
See the Platform in ActionExplore Case Studies
MORE THAN TOOLS. MORE THAN PROMISES.
Care, connected. Outcomes proven.
We deliver strategic insight, a trusted platform, and embedded operational partnership—so care systems don't just work, they thrive.
96
%
Return to work / Ready to return to work.
Recovery, realized.
92
%
Patients satisfied with quality of care.
Care That Delights.
34
%
Reduction in cost per case over 3 years.
Efficiency, engineered.
88
%
Patients spared unnecessary imaging.
Smarter, Safer Decisions.
Hand placing a red gear among interconnected silver gears on a metallic surface.
We work alongside insurers, providers, and employers to solve what matters most—disconnected systems, inefficient workflows, and care models that don’t scale.
Portrait of a middle-aged man with gray hair, glasses, wearing a dark suit jacket and white shirt against a plain background.
Nizar Mahomed
CEO & Co-Founder
Dashboard showing bar and line charts with healthcare-related data metrics on a dark background.
OUR PARTNERSHIP PATHWAY
Start Where You Are. Scale to Where You Need to Be.
Our partnership model is flexible. Whether you're starting with data strategy or ready for full-scale operational transformation, we have a clear pathway to success.
01
Insight Starter.
Build a strong data foundation and unlock immediate value. We help you define your data strategy and KPIs, interpret insights from your existing data, and develop a clear roadmap for analytics adoption.
02
Efficiency Optimizer.
Streamline workflows and enhance care coordination for measurable efficiency. We analyze current operations, identify bottlenecks, redesign care pathways, and help implement change management to improve service delivery.
03
Care Transformation.
Lead holistic, system-wide change with confidence. We partner with you to design, execute, and operate future-ready care models, integrating our platform and expertise to achieve your most ambitious strategic goals.
Discuss Your NeedsMeet Our Leadership Team
CASE STUDY HIGHLIGHTS

Orchestration in Action. Proven Results.

We partner with Insurers & Payers to design and operate programs that deliver measurable, real-world impact.
Driving Integrated Care Through Expert Advisory and Strategic Partnerships
Arthur Health empowers coordinated care and expert advisory services with The Ottawa Hospital for Ontario’s largest IDN for workplace injuries.
Result
37,000+
Injured workers served with over 750,000 coordinated healthcare services from 2018-2024
Ontario Workers Network (OWN): Transforming Care for Injured Workers
Integrated care network leveraging CareNexus to streamline recovery, improve outcomes, and empower injured workers across Ontario.
Result
90%
Return-to-work success rate achieved across the network.
GET STARTED

Ready to deliver high-value coordinated healthcare?

We offer proven solutions for every stakeholder. Let’s build a smarter, more connected health system together.
Black and white portrait of a confident bearded man in a suit with arms crossed against a light background.
Raj Rampersaud
Co-Founder & CMO
Schedule Your Strategy Call