Injury Evaluation
Liability & Injury Evaluation Software
Enlyte's ClaimIQ® is your complete third party claim solution to improve accuracy, consistency and cycle time for liability and injury evaluations. 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
A comprehensive claim evaluation tool, Enlyte's ClaimIQ helps you arm your adjusters—regardless of their experience—with the information they need to make more accurate settlements on each and every claim, through a streamlined workflow and integrated environment. The ClaimIQ customer sees a 5% average liability reduction, which translates to $9.8 million dollars in loss cost reductions for every 10,000 BI and PD exposures. ClaimIQ also helps carriers improve evaluation time by 40% cycle time from evaluation to settlement. Enlyte's injury evaluation capabilities allows adjusters to consistently and comprehensively document their injury evaluations.
How it Works
Assess Liability
Consistently identify, document and pursue comparative negligence opportunities. Based on a tort-duty framework that integrates with investigation, adjusters are able to consistently identify comparative negligence with claim-specific facts that provide a clear rationale.
Conduct Investigations
Flexible and scenario-driven model ensures that adjusters consistently gather the facts needed to drive better claims outcomes. Integrates with data already collected at FNOL to structure the facts of loss in a way that can be re-surfaced during negotiation, subrogation and the reporting and analytics stage.
Evaluate General Damages
ClaimIQ employs best practices approach to help adjusters understand and explain pain and suffering recommendations.
Conduct Thorough Investigations & Assess Liability
Establishing a consistent approach to liability and injury evaluation is one of the most important steps a carrier can take when building their third party workflow. Without a programmatic approach to assess and calibrate liability and injury across the organization, adjuster teams will inevitably diverge in their claims handling practices. Help optimize comparative negligence and improve injury evaluation accuracy using Enlyte's injury and liability assessment software.
The Enlyte Knowledgebase Best Practices Model
Establishing a consistent approach to liability and injury evaluation is one of the most important steps a carrier can take when building their third party claims workflow. Without a programmatic approach to assess and calibrate liability and injury across the organization, adjuster teams will inevitably diverge in their claims handling practices.
Selecting a liability and evaluation recommendation model can help improve consistency and accuracy, but it may be difficult to determine which type of model is right for your organization. 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, but adjusters using it may struggle to explain the exact reasons for their evaluations based on the recommendations and may leave certain claims unaddressed.
Enlyte Knowledgebase Best Practices Model:
Built based on your organization’s claim handling philosophies. This model helps adjusters prepare for negotiations and defend their evaluations, regardless of their experience, as the recommendations are based on best practices to provide clear explanations and reasoning for why they were made.
Not sure if the best practices approach is right for you? Read Enlyte's FREE guide that compares the best practices model with the industry’s other popular approach: the historical data statistical model.
Optimize Comparative Negligence Results
Enlyte's ClaimIQ Improves accuracy of liability through consistent evaluation and guides adjusters through liability assessment to more precisely identify shared liability. The platform automatically incorporates liability decisions into claim negotiation and allows users to access critical information, such as rules of the road, vehicle codes and historical weather-specific data to where, how and when the claim incident occurred.
Improve Injury Evaluations
Enlyte's ClaimIQ is a comprehensive evaluation tool that includes medicals, pain and suffering, permanency, venue and impact on lifestyle and ensures a consistent approach to claim evaluation based on your best practices. ClaimIQ assists your adjusters with built-in guidance linked to your best practices and helps them evaluate general damages using a best practices model.
ClaimIQ creates a streamlined user experience for adjusters with pre-integration with Enlyte's bill review and services processing for demand processing, medical specials evaluations, nurse reviews and medical referrals. Additionally, the solution provides management reporting on key performance metrics at a company, team and adjuster level.
Benefits Across the Organization
Claims Executives
ClaimIQ provides the following features and benefits for claims executives:
- Consistent evaluation practices to help ensure loss cost consistency.
- Integration capabilities to help reduce the total cost of ownership and improve efficiency.
- Enlyte advanced reporting and analytics, enabling your leadership to effectively and consistently manage operations and harness the power of perspective.
Claims Manager
ClaimIQ provides the following features and benefits for claims managers:
- Assessment parameters are customized to your best practices, improving claims handling skills across the whole organization.
- Guidance to drive consistent and accurate evaluation results.
- Analytics dashboards to manage operations and lead teams to better outcomes
Claims Adjuster
ClaimIQ provides the following features and benefits for claims adjusters
- Simple-to-use, streamlined interface for quick and easy adoption.
- All-in-one solution for capturing claim details and artifacts.
- Negotiation strategy planning based on facts documented throughout the evaluation lead to quicker, more accurate settlements.
Find Out More
Combine industry-leading technology with deep market expertise to achieve exceptional claim outcomes. Schedule a consultation to learn more about our comprehensive suite of integrated casualty services and solutions.