Identifies Six Key Technology-Enabled Areas for Effective Management of Bodily Injury Claims
ISO has identified a six-point strategy where technology now exists for the effective management of claims through improved visibility of the claims handling process, establishing Best Practices and a more accurate assessment of injuries and recovery implications.
Statistics from the Insurance Research Council (IRC) have shown that claims cost inflation has risen at an average of around seven percent every year since 1997 � with the average bodily injury claim cost rising from $4,804 in 1997 to $6,711 in 2002. In line with this, ISO’s research has shown that the number one goal for insurers is reducing claims handling costs. Fifty-eight percent of insurers identified increased staff knowledge and training as the key concern, while 25 percent cited enhanced claim handler efficiency.
THE SIX KEY AREAS:
Identifying Industry Trends
Powerful tools are available to provide real-time company-wide and industry-wide benchmarks for claims and for costs of associated services
Visibility of the Claims Handling Process
A number of new techniques in tracking claims activity enables handlers to produce more accurate and consistent settlements, empowers them in the negotiating process and assists management in providing needs-based training for staff
Comprehensive Management Information
Detailed management information enables supervisors to monitor claims handler activity so that Best Practice is adhered to and the management of claims remains efficient
Granularity of Injury Assessment
Injury identification based on internationally-recognized coding and an integrated medical encyclopedia allows for a more accurate assessment of an injury’s severity, recovery prognoses and rehabilitation
Detailed Medical Protocols and Recovery Profiles
Linking likely treatments to injuries helps ensure very accurate settlements and identify unnecessary treatments. Coupled with responsive severity ratings, organizations can create updatable recovery profiles to enhance the accuracy of claims estimates
Accurate Loss of Earnings Estimate
Integrating national earnings statistics and incorporating more factors into claims assessment processes makes estimates more precise
“Reducing claims handling costs by settling a claim fairly, equitably and as quickly as possible is in everyone’s interest,” commented Lee Fogle, Vice President of ISO. “There are many factors involved in achieving this and we want to help the insurance industry as a whole drive towards these targets.”
ISO provides a Measures of Excellence service, which carries out a full review of an insurance organization’s closed bodily injury claims files and workflow processes. ISO experts track supervisory and claims handler practices through a rating system based on six critical file-handling areas � control, investigation, evaluation, negotiation, settlement and compliance. The data from these processes is then analyzed and measured against industry best practices to create benchmarks, enabling a client organization to maximize its own best practices and exceed industry standards.
ISO Claims Outcome Advisor� (COA�)
ISO Claims Outcome Advisor is an innovative system that helps claims handlers administer the multiple dimensions of bodily injury claims.
Relying on state-of-the-art technology, Claims Outcome Advisor helps them in effectively managing the unique and increasingly complex medical, legal and occupational issues presented by bodily injury claims.
Claims Outcome Advisor helps claims handlers learn to negotiate consistent and appropriate financial settlements and manage all aspects of bodily injury cases – from the first-notice-of-loss to return-to-work plans, rehabilitation and final settlements.
ISO Claims Outcome Advisor helps manage injury claims through a knowledge database of an insurer’s historical data; well-defined claims auditing capabilities; ongoing staff training on claims and medical factors; and implementation of an insurer’s best practices. As a result, COA helps insurers achieve their goal of paying the right amount at the right time for injury claims.
About ISO Liability Advisor™
ISO also offers ISO Liability Advisor, a powerful tool to help claims professionals better evaluate accident-related comparative liability claims. ISO Liability Advisor features a relational database that helps claims handlers report, manage and track comparative liability claims.
With ISO Liability Advisor, insurers can streamline the assessment process, settle cases consistently, quickly identify more cases involving comparative liability, improve accuracy in assessing comparative liability and assemble a logical negotiating strategy.
ISO Liability Advisor makes it easy to navigate even the toughest comparative liability cases � consistently, and efficiently. The solution is a knowledge sharing tool that can help train the newest team members.
Using ISO Liability Advisor, a claims handler can quickly gather and store relevant information, including state laws, accident reports and electronic accident scene diagrams. With the supporting information, claims personnel are better equipped to attribute the fair percentage of liability to claims and eliminate the “all-or-nothing” outcomes in claims practices.
ISO is a leading provider of products and services that help measure manage and reduce risk. ISO provides data, analytics and decision-support solutions to professionals in many fields, including insurance, finance, real estate, health services, government and human resources. Clients use ISO’s databases and services to classify and evaluate a variety of risks and detect potential fraud. In the US and around the world, ISO’s services help customers protect people, property and financial assets.