CLARIVO is an informational and decision-support tool. It does not underwrite insurance policies, adjudicate claims, represent insurance carriers, or provide certified legal or medical advice. By using CLARIVO, you agree that final insurance claim determinations belong solely to your insurer or third-party administrator (TPA).
1. Acceptance of Terms & Eligibility
These Terms of Service (“Terms”) constitute a legally binding agreement between you (“User,” “you,” or “your”) and CLARIVO Systems Inc. (“CLARIVO,” “we,” “us,” or “our”). By creating an account, uploading documents, accessing our API, or browsing this website, you represent and warrant that:
- You are at least 18 years of age and possess legal capacity to enter into binding agreements.
- You have the legal authority or explicit consent of the policyholder to upload any insurance policy schedules, medical summaries, or billing records you submit.
- You agree to comply fully with these Terms and all applicable local, state, national, and international laws.
2. Platform Description & Permitted Scope of Use
CLARIVO provides software tools designed to parse and structure health insurance contracts, highlight sub-limits, cross-reference medical diagnoses against policy waiting periods, and compute hypothetical financial simulations.
- An evidence-grounded document comprehension copilot
- A deterministic financial scenario sandbox
- A pre-hospitalization checklist assistant
- A clause verification and provenance reader
- An insurance carrier, underwriter, broker, or agent
- A medical diagnostics or treatment provider
- A binding claim settlement or approval system
- A substitute for professional legal or medical advice
3. Epistemic Classification & Non-Guarantee of Claim Settlement
CLARIVO enforces an epistemic integrity model that separates Verified Facts (explicitly quoted in your uploaded policy wording with character offsets) from User-Stated Attributes, System Inferences, and Unknowns.
If a specific coverage clause or disease rider cannot be located in the documents you provide, CLARIVO flags this as Unknown / Missing Evidence. The absence of a clause in a partial document does not constitute proof that your policy covers or excludes that condition. You are solely responsible for providing complete, unabridged policy terms.
No Guarantee of Payout: Under no circumstances does CLARIVO promise, warrant, or guarantee that any insurance claim submitted by you will be approved, partially approved, or paid by an insurer. Insurance companies evaluate claims based on original certified contracts, doctor case sheets, network agreements, and independent medical auditor opinions.
4. Prohibited Uses & Account Conduct
You agree that you will NOT:
- Upload fraudulent, falsified, or forged insurance policies or medical hospital estimates.
- Attempt to reverse-engineer, decompile, or extract the underlying algorithms or rules engines of CLARIVO.
- Circumvent multi-tenant isolation, perform directory traversal attacks, or attempt unauthorized access to other workspaces.
- Use automated bots, scrapers, or scripts to flood our ingestion endpoints or overwhelm API capacity.
- Rely on CLARIVO during emergency, life-threatening medical situations in lieu of immediate emergency medical services.
5. Intellectual Property & User Ownership
Your Documents Remain Yours: You retain complete and exclusive ownership, title, and intellectual property rights in all documents, medical bills, and text you upload to CLARIVO. You grant CLARIVO only a limited, non-exclusive license to process, parse, and store such data solely for the purpose of providing services to your workspace.
CLARIVO Intellectual Property: All software architecture, user interfaces, logos, brand assets, simulation algorithms, and documentation remain the exclusive property of CLARIVO Systems Inc.
6. Limitation of Liability & Warranty Disclaimer
DISCLAIMER OF WARRANTIES
THE CLARIVO PLATFORM, SERVICES, AND ALL INTELLIGENCE OUTPUTS ARE PROVIDED ON AN “AS-IS” AND “AS-AVAILABLE” BASIS WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT.
CAP ON CONSEQUENTIAL DAMAGES
TO THE MAXIMUM EXTENT PERMITTED BY LAW, CLARIVO SYSTEMS INC. AND ITS DIRECTORS, OFFICERS, EMPLOYEES, AND AGENTS SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING CLAIM DENIALS, DEDUCTION LOSSES, DELAYED HOSPITAL ADMISSIONS, OR OUT-OF-POCKET EXPENSES ARISING OUT OF OR IN CONNECTION WITH YOUR USE OF THE PLATFORM.
7. Governing Law & Dispute Resolution
These Terms shall be governed by and construed in accordance with the laws of the State of Delaware (or applicable local jurisdiction), without regard to its conflict of law principles. Any dispute arising out of or relating to these Terms shall be resolved through confidential binding arbitration or competent courts having jurisdiction.