Claims

Claims Outcome Advisor

Get insights to enhance personal injury claims handling

Manage personal injury claims more effectively from end to end with the Claims Outcome Advisor (COA) Suite. The enhanced suite of tools leverages powerful analytics to help claims professionals reduce life cycles, minimise risks, and improve efficiency.

Identify injury severity and value claims with advanced analytics

Analytics

Identify injury severity and value claims with advanced analytics

Inaccurate and inconsistent injury claim settlements can cause unnecessary spend for compensators. COA identifies injury severity accurately and arrives at consistent and fair general damage valuations by using advanced analytics to compare claims to similar cases and historical data. The solution uses a unique severity index and profile—covering over 18,000 medical conditions—to monitor, assess, and value personal injury claims.

Improve event and entity resolution

Resolution

Improve event and entity resolution

With a second claims portal, identifying related claims is critical—especially with the potential of the same claim being submitted to both portals. Automated features will alert claims professionals to claims of interest to ensure associated claims are considered and appropriately investigated.

COA seamlessly integrates with the Ministry of Justice (MoJ) Claims Portal and Official Injury Claim Portal and has helped insurers process more than 2 million claims.

Manage claims proactively with next best action

Manage

Manage claims proactively with next best action

Improve claim outcomes and ensure appropriate reserves throughout the life of a claim with tools that promote proactive claims management. By analysing the various actions and decisions during a claim’s life cycle, data helps drive strategies and provide claims professionals with the insights to make informed decisions throughout.

Leverage AI to automate medical report assessment

Medical Report

Leverage AI to automate medical report assessment

Under the new whiplash reforms, every personal injury claim requires a medical report, which could lead to delays in processing. The medical report reader feature uses AI to triage, capture, and automatically populate the injury assessment tool, so insurers can quickly and easily assess medical evidence.

Uncover trends to improve decision making

Trends

Uncover trends to improve decision making

Insurers can better respond to behavioural changes that affect compensation with key insights derived from data analysis. COA continuously captures, analyses, and monitors a wealth of data to help you make better-informed decisions.

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