Claims Adjuster Tools
Liability & Injury Evaluation Software
Enlyte的ClaimIQ®是您完整的第三方索赔亚博真人官方版APP,可提高准确性, 责任和伤害评估的一致性和周期时间. ClaimIQ is built using your own claims handling philosophies, fact-based recommendations and best practices, making it truly unique to your organization’s needs.
Consistent Liability & Injury Evaluations
ClaimIQ is built on your own claims handling philosophies, and best practices, rather than historical data. A comprehensive claim evaluation tool, Enlyte ClaimIQ帮助您武装您的理赔员,无论他们的经验如何,他们都需要更准确地解决每一项索赔, through a streamlined workflow and integrated environment. ClaimIQ客户的平均责任减少了5%,也就是9美元.8 million dollars in loss cost reductions for every 10,000 BI and PD exposures and a 5% average liability reduction.* ClaimIQ还帮助运营商将评估时间从评估到结算的周期时间缩短了40%. Enlyte的损伤评估功能允许调整员一致和全面地记录他们的损伤评估.
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Assess Liability
始终如一地识别、记录和寻找比较过失的机会. 基于侵权责任与侦查相结合的框架, 理算员能够始终将比较过失与提供明确理由的索赔特定事实相鉴别.
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Conduct Investigations
灵活和场景驱动的模型确保理算员始终如一地收集所需的事实,以推动更好的索赔结果. 与FNOL已经收集的数据相结合,以一种可以在谈判期间重新浮出水面的方式构建损失事实, subrogation and the reporting and analytics stage.
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Evaluate General Damages
ClaimIQ采用最佳实践方法来帮助理赔员理解和解释疼痛和痛苦建议.
Conduct Thorough Investigations & Assess Liability
建立一致的责任和伤害评估方法是运营商在建立第三方工作流程时可以采取的最重要的步骤之一. 没有一个程序化的方法来评估和校准整个组织的责任和伤害, 理算员团队在理赔实践中不可避免地会出现分歧. 使用Enlyte的伤害和责任评估软件,帮助优化比较过失和提高伤害评估的准确性.
The Enlyte Knowledgebase Best Practices Model
建立一致的责任和伤害评估方法是承运人在建立第三方索赔工作流程时可以采取的最重要的步骤之一. 没有一个程序化的方法来评估和校准整个组织的责任和伤害, 理算员团队在理赔实践中不可避免地会出现分歧.
选择责任和评估推荐模型有助于提高一致性和准确性, 但是确定哪种类型的模型适合您的组织可能很困难. Here’s a quick breakdown as to how the models differ:
- Typical Pure Statistical Model: Built based on historical claims data. Quick to stand up, 但使用它的理算员可能很难解释他们基于建议进行评估的确切原因,可能会留下某些索赔未解决.
- Enlyte Knowledgebase Best Practices Model: 基于贵公司的索赔处理理念. 这个模型帮助调整者为谈判做好准备,并为他们的评估辩护, regardless of their experience, 由于这些建议是基于最佳实践的,因此对提出这些建议的原因提供了清晰的解释和推理.
Not sure if the best practices approach is right for you? 阅读Enlyte的免费指南,其中比较了最佳实践模型和行业中另一种流行的方法:历史数据统计模型
Optimize Comparative Negligence Results
Enlyte的ClaimIQ通过一致的评估提高了责任的准确性,并通过责任评估指导理赔员更精确地识别共同责任. 该平台自动将责任决策纳入索赔谈判,并允许用户访问关键信息, such as rules of the road, vehicle codes and historical weather-specific data to where, how and when the claim incident occurred.
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Improve Injury Evaluations
Enlyte的ClaimIQ是一种综合评估工具,包括医疗工具, pain and suffering, permanency, 地点和对生活方式的影响,并确保基于您的最佳实践的索赔评估方法的一致性. ClaimIQ为您的理算员提供与您的最佳实践相关联的内置指导,并帮助他们使用最佳实践模型评估一般损害.
ClaimIQ为理算员创建了一个简化的用户体验,预先集成了Enlyte的账单审查和服务处理,用于需求处理, medical specials evaluations, nurse reviews and medical referrals. Additionally, 该亚博真人官方版APP为公司的关键绩效指标提供管理报告, team and adjuster level.
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Claims Executives
Benefits Across the Organization
ClaimIQ为理赔管理人员提供以下功能和好处:
- 一致的评估实践有助于确保损失成本的一致性.
- 集成功能有助于降低总体拥有成本并提高效率.
- Enlyte advanced reporting and analytics, 使您的领导能够有效和持续地管理业务,并利用观点的力量.
Claims Manager
Benefits Across the Organization
ClaimIQ为理赔经理提供以下功能和好处:
- Assessment parameters are customized to your best practices, improving claims handling skills across the whole organization.
- Guidance to drive consistent and accurate evaluation results.
- 分析仪表板来管理运营并领导团队取得更好的成果
Claims Adjuster
Benefits Across the Organization
ClaimIQ为理赔员提供了以下功能和好处
- 简单易用,流线型的界面,快速和容易采用.
- All-in-one solution for capturing claim details and artifacts.
- 谈判策略规划基于整个评估过程中记录的事实导致更快, more accurate settlements.
*ISO claim settlement values of $16k per BI claim and $3.7K per PD claim.
For 10,000 PD claims carriers see $1,850,000.00 reduction in settlement values. • For every 10,000 BI claims carriers see $8,000,000.00 reduction in settlement values.
Data taken from 2018 ISO claim data.