So, you read that Mavera DSS is a cloud platform that can make your claims process more accurate and efficient, but you still might not fully grasp what the platform does.
This article is for you.
Where does Mavera DSS fit into the claims process?
First, let's cover where you can use Mavera DSS. The system is beneficial for any claim involving an injured person, such as traffic accidents, travel insurance, medical malpractice, maternity insurance, workers' compensation, or accident and health insurance.
DSS stands for Decision Support System, which describes how it is used in the claims process – to make claims decisions.
A typical claims process includes the following steps:
- First notice of loss (FNOL)
- Assigning the claim to a claims handler
- Coverage verification
- Collecting materials like medical records and police reports
- Reading the materials to understand the injury
- Getting medical assessments, if needed
- Making a decision
- Settlement and informing the claimant about the decision
- Performance management and optimizing the process
Mavera DSS enhances steps 5, 6, 7, and 9.
Health insurance follows a slightly different process; we have detailed how we support it in this article.
How Mavera DSS supports four steps
Step 5: Reading the materials to understand the injury
Analyzing claims documentation is often can be the most time-consuming part of the process. For complicated claims, there can be over 500 pages of medical records, x-rays, police reports, and other documentation that the claims handler must read to understand the injury. This can take several hours or even days.
Using AI, Mavera DSS automatically summarizes and visualizes all this information in a clear overview, making it easier for the claims handler to digest the information and reducing the risk of missing any crucial details. What used to take hours now takes seconds, significantly accelerating the claims process and freeing up valuable time for your team.
See how it works in this 2:30-minute video, or read more here.
Step 6: Getting medical assessments
Receiving medical assessments is another critical area that has traditionally been a bottleneck for many insurers. Contracting a sufficient network of medical advisors and building an efficient and secure process for medical assessments is resource-intensive. If not streamlined, it can become a problem rather than a support in the claims process.
Read more about the importance of a streamlined process for medical assessments.
We solve this in two ways:
- We offer the largest network of medical advisors in the Nordic region, accessible through Mavera DSS. Learn more about our network.
- Insurers can use Mavera DSS to manage their own network of medical advisors and streamline the assessment process. Read more about these functionalities.
A common setup combines these approaches, using our network and internal medical advisors within the same system, ensuring that you always have access to the expertise you need.
Watch this 2-minute video to see how it works.
Step 7: Decision making
After reviewing all documentation and possibly receiving a medical advisor's assessment, the claims handler can make a decision. Mavera DSS supports the decision phase by enabling claims handlers to collaborate efficiently and share claims with colleagues. With all the information clearly presented, it's quick for a colleague to provide a second opinion on a claim before the decision is finalized.
The system also provides a decision report that the claims handler can share with the claimant to explain the decision, enhancing transparency and trust.
Step 9: Performance management and optimizing the process
This extensive process requires constant optimization. Considering the enormous costs associated with claims management, even minor improvements can have a significant impact. Mavera DSS empowers your decision-making with comprehensive insights into every aspect of your claims business, enabling data-driven decision-making, operational efficiency, and strategic business planning.
All relevant data in the system are visualized in dashboards and reports, giving you the tools to identify bottlenecks and continuously improve your processes.
Read more or watch this 1-minute video about our claims reports.
The results
Our customers see significant results from implementing Mavera DSS, with benefits that include:
- Up to 10 times faster claims handling times, allowing their team to process more claims in less time and improve customer satisfaction.
- More accurate claims decisions, reducing the incidence of over- or underpayments and minimizing the risk of costly litigations.
- The ability to collect and analyze structured data, leading to better operations and business decisions.
- Ensured compliance with GDPR and DORA, simplifying audits, and reducing the risk of data breaches or penalties.
These improvements can save millions of euros in reduced loss adjustment expenses (LAE), claims payouts, and litigation costs for large insurers. By streamlining your claims process with Mavera DSS, you not only boost efficiency but also gain a competitive edge in the market.
Our goal is to simplify the adoption of advanced technology for insurance companies by offering these capabilities in a user-friendly SaaS platform. It can be integrated into your core system or used as a stand-alone solution for quick implementation.