One of the most complex tasks in personal injury claims is determining the extent of a long-term disability caused by an injury.
Based on medical evaluations and records, the claims handler must understand when and how the injury happened, if the disability is stable or if it will get better, and what long-term consequences it will lead to.
It's a time-consuming and tedious process critical for the company's operations. The efficiency and accuracy of this process will have consequences on the company's financial results. As this of course is a very stressful situation for the customer, a transparent and fast experience is key to high customer satisfaction.
4 ways Mavera DSS supports this:
- The first thing the claims handler must do is to structure and read the claims documentation. Mavera supports this using intelligent document processing (IDP) technology to scan the document and extract relevant information and events automatically. Presented in a clear case overview, the claims handler can read up on a case faster, minimizing the risk of missing any important information.
- The system uses prediction models for medical disability and diagnosis to suggest the next actions to help understand the claim.
- If a colleague or medical advisor should review the case, the system securely streamlines that process too. Templates and automatic assignments make getting the answers you need easy.
- Mavera DSS automatically generates a custom assessment report describing how the assessment was made, what information was used, and what questions were asked.
The result
Depending on previous processes, our customers see different results from implementing Mavera DSS. Some common results are:
- The claims process becomes more efficient, with up to 50% shorter claims handling times.
- Their claims decisions become more accurate, leading to fewer over- or underpayments.
- As the whole process is unified and digital, they can start collecting structured data, enabling them to improve their operations and business decisions.
- The secure system simplifies audits and removes the risk of data breaches or penalties.
Combining these results saves millions of euros in reduced loss adjustment expenses (LAE), claims payouts, and litigations for a large insurer.