Terms of Service

These Terms of Service ("Terms") govern your access to and use of the ClaimFlow web application and related services (collectively, the "Service") provided by ClaimFlow ("we," "us," or "our"). By accessing or using the Service, you ("Customer" or "you") agree to be bound by these Terms. If you are using the Service on behalf of an organization, you represent that you have the authority to bind that organization to these Terms.

1. Description of Service

ClaimFlow is a web-based platform that uses artificial intelligence to process insurance claim documents. The Service allows users to upload Xactimate PDF estimates, extract line item data using AI, review and select items, perform payment calculations, and generate professional reports.

2. Account Registration

To use ClaimFlow, you must create an account through our authentication provider (Clerk). You agree to: (a) provide accurate and complete information during registration; (b) keep your account information up to date; (c) maintain the confidentiality of your account credentials; (d) immediately notify us of any unauthorized use of your account; and (e) accept responsibility for all activities that occur under your account. You may not share account credentials with unauthorized individuals or create accounts for others without their permission.

3. Subscriptions and Billing

3.1 Plans and Pricing

ClaimFlow offers the following subscription plans:

• Free Tier: 1 claim to try the full experience. No credit card required.
• Starter ($99/month): 10 claims per billing period
• Professional ($199/month): 20 claims per billing period
• Enterprise ($349/month): 40 claims per billing period

Each PDF upload counts as one claim, whether processed individually or as part of a batch. Unused claims do not roll over to the next billing period.

3.2 Billing Terms

• Subscriptions are billed monthly in advance through Stripe
• When your claim limit is reached, the Service will prevent further claim processing until you upgrade or your next billing period begins
• You may upgrade or downgrade your plan at any time; changes take effect at the start of the next billing period
• We reserve the right to change pricing with 30 days advance notice
• You are responsible for all applicable taxes

3.3 Cancellation and Refunds

You may cancel your subscription at any time through the Stripe billing portal. Upon cancellation, you will retain access to the Service until the end of your current billing period. Refund requests are handled on a case-by-case basis; contact support@tryclaimflow.com for assistance.

4. Acceptable Use

You agree to use ClaimFlow only for lawful purposes related to insurance claim processing. You may not:

• Upload documents you do not have the legal right to process
• Use the Service to process claims fraudulently or facilitate insurance fraud
• Upload fraudulent, fabricated, or deliberately misleading documents to manipulate AI outputs
• Use AI outputs as the sole basis for any adverse claim determination without human review
• Attempt to reverse-engineer, decompile, or extract the underlying AI models or algorithms
• Circumvent usage limits, billing controls, or security measures
• Share account credentials or allow unauthorized access to the Service
• Use the Service to discriminate against individuals based on protected characteristics
• Use the Service in violation of applicable insurance regulations
• Use automated tools to scrape, crawl, or access the Service outside of normal use

Violation of these terms may result in immediate suspension or termination of your account without refund.

5. Data Ownership and Licensing

5.1 Your Data

As between ClaimFlow and you, you retain all right, title, and interest in your data, including all documents uploaded to the Service and all information contained therein ("Customer Data"). ClaimFlow claims no ownership rights over Customer Data.

5.2 License to ClaimFlow

You grant ClaimFlow a limited, non-exclusive, non-transferable license to process Customer Data solely for the purpose of providing the Service. This license terminates upon termination of your account.

5.3 AI-Generated Outputs

You own all AI-generated outputs derived from your uploaded documents, including extracted line items, calculations, and generated reports. Due to the nature of artificial intelligence and machine learning, AI outputs may not be unique and the Service may generate the same or similar outputs for different customers processing similar documents.

5.4 No Training on Customer Data

ClaimFlow does not use Customer Data to train, improve, or fine-tune AI models. Customer Data is processed solely to deliver the Service. Our AI provider (Anthropic) does not use API-submitted data for model training.

6. AI Accuracy and Disclaimers

6.1 Human Review Requirement

You acknowledge and agree that:

• All AI-generated outputs must be reviewed by qualified personnel before being relied upon for any claim decision
• The Service is designed to assist, not replace, human judgment in insurance claim processing
• You shall not use AI outputs as the sole basis for any adverse claim determination
• ClaimFlow is not providing insurance advice, legal advice, or professional claim adjudication services

6.2 Accuracy Limitations

AI extraction accuracy may be affected by document quality, formatting variations, handwritten annotations, non-standard layouts, image quality, and other factors beyond our control. While we continuously work to improve accuracy, we cannot guarantee error-free extraction for every document. You should independently verify all extracted data, calculations, and generated reports before professional use.

7. Disclaimer of Warranties

THE SERVICE IS PROVIDED "AS IS" AND "AS AVAILABLE" WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, AND NON-INFRINGEMENT. CLAIMFLOW DOES NOT WARRANT THAT THE SERVICE WILL BE UNINTERRUPTED, ERROR-FREE, SECURE, OR FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. CLAIMFLOW DOES NOT WARRANT THE ACCURACY, RELIABILITY, OR COMPLETENESS OF ANY AI-GENERATED OUTPUT.

8. Limitation of Liability

TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL CLAIMFLOW BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING BUT NOT LIMITED TO LOSS OF PROFITS, DATA, BUSINESS OPPORTUNITIES, OR GOODWILL, ARISING OUT OF OR IN CONNECTION WITH YOUR USE OF THE SERVICE, REGARDLESS OF THE THEORY OF LIABILITY.

CLAIMFLOW'S TOTAL AGGREGATE LIABILITY FOR ANY AND ALL CLAIMS ARISING OUT OF OR RELATED TO THESE TERMS OR THE SERVICE SHALL NOT EXCEED THE TOTAL AMOUNT PAID BY YOU TO CLAIMFLOW IN THE TWELVE (12) MONTHS PRECEDING THE EVENT GIVING RISE TO THE CLAIM, OR ONE HUNDRED DOLLARS ($100), WHICHEVER IS GREATER.

ClaimFlow shall not be liable for any losses, damages, or claims arising from: (a) reliance on AI-generated outputs without independent verification; (b) decisions made based solely on automated processing without human review; (c) inaccuracies in data extraction caused by poor document quality, handwriting, or non-standard formatting; or (d) any use of the Service that violates these Terms.

Some jurisdictions do not allow the exclusion or limitation of certain damages. In such jurisdictions, the limitations above shall apply to the fullest extent permitted by applicable law.

9. Indemnification

You agree to indemnify, defend, and hold harmless ClaimFlow and its officers, directors, employees, and agents from any third-party claims, damages, losses, liabilities, and expenses (including reasonable attorneys' fees) arising from: (a) your use of the Service in violation of these Terms; (b) your violation of applicable law, including insurance regulations; (c) Customer Data, including any claims that your uploaded content infringes third-party rights; (d) your reliance on AI outputs without appropriate human review; or (e) your negligence or willful misconduct.

10. Intellectual Property

The ClaimFlow platform, including its design, code, AI integrations, user interface, documentation, and trademarks, is the intellectual property of ClaimFlow and is protected by applicable intellectual property laws. These Terms do not grant you any rights to use ClaimFlow's trademarks, logos, or brand features without prior written consent. You retain all intellectual property rights in your Customer Data and AI-generated outputs as described in Section 5.

11. Data Processing

By using ClaimFlow, you acknowledge that your uploaded documents will be processed using third-party AI services (Anthropic Claude API) for the purpose of extracting claim data. Documents are processed via API calls and are not stored by the AI provider for model training. Please refer to our Privacy Policy for complete details on how we collect, use, store, and protect your data.

12. Termination

Termination by You: You may close your account at any time by contacting us at support@tryclaimflow.com. You may request data export prior to account closure.

Termination by ClaimFlow: We reserve the right to suspend or terminate your account immediately if you violate these Terms, engage in fraudulent activity, or pose a security risk to the Service or other users. We may also terminate inactive accounts with 30 days prior notice.

Effect of Termination: Upon termination, your right to use the Service ceases immediately. We will delete your data in accordance with the retention schedule described in our Privacy Policy. Sections 6 through 9 (Disclaimers, Liability, Indemnification) and Section 13 (Dispute Resolution) shall survive termination.

13. Dispute Resolution

13.1 Informal Resolution

Before filing any formal dispute, you agree to attempt to resolve the matter informally by contacting us at support@tryclaimflow.com. We will attempt to resolve the dispute through good-faith negotiation within 30 days.

13.2 Binding Arbitration

If informal resolution fails, any dispute arising out of or relating to these Terms or the Service shall be resolved by binding arbitration under the rules of the American Arbitration Association (AAA) Commercial Arbitration Rules. The arbitration shall be conducted by a single arbitrator, and judgment on the award may be entered in any court of competent jurisdiction. Either party may bring claims in small claims court as an alternative to arbitration.

13.3 Class Action Waiver

EACH PARTY MAY ONLY BRING CLAIMS AGAINST THE OTHER IN AN INDIVIDUAL CAPACITY AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY CLASS, CONSOLIDATED, OR REPRESENTATIVE ACTION. YOU AGREE TO WAIVE ANY RIGHT TO PARTICIPATE IN A CLASS ACTION LAWSUIT OR CLASS-WIDE ARBITRATION.

13.4 Governing Law

These Terms shall be governed by and construed in accordance with the laws of the State of Delaware, without regard to its conflict of laws principles. Either party may seek injunctive relief in any court of competent jurisdiction for breach of intellectual property rights or confidentiality obligations.

14. General Provisions

• Entire Agreement: These Terms, together with our Privacy Policy and any other agreements referenced herein, constitute the entire agreement between you and ClaimFlow.
• Severability: If any provision of these Terms is found unenforceable, the remaining provisions shall continue in full force and effect.
• Waiver: Failure to enforce any right or provision of these Terms shall not be deemed a waiver of that right or provision.
• Assignment: You may not assign your rights under these Terms without our prior written consent. We may assign our rights in connection with a merger, acquisition, or sale of assets.
• Force Majeure: Neither party shall be liable for delays or failures in performance resulting from causes beyond their reasonable control, including natural disasters, pandemics, acts of government, or failures of third-party services.

15. Changes to These Terms

We may update these Terms from time to time. We will notify you of material changes by posting a prominent notice on our website or by sending you an email at least 30 days before the changes take effect. Your continued use of ClaimFlow after the effective date of any changes constitutes acceptance of the updated Terms. If you do not agree with the changes, you must stop using the Service before they take effect.

16. Contact

For questions about these Terms of Service, please contact us:

• Email: support@tryclaimflow.com
• Contact Page: tryclaimflow.com/contact