Insurance Services Office, Inc. (ISO) has signed an agreement to integrate its ClaimDirectorSM auto physical damage (APD) claim score with the ClaimsPortTM solution from ProcessClaims to enable systematic evaluation of incoming claims via web services at first notice of loss.
ClaimDirector is ISO’s proprietary expert, rules-based claims-scoring service. The ClaimDirector-APD service is specific to auto physical-damage claims.
This integrated solution will reportedly provide claims adjusters and SIU units critical information to help them detect potential fraud at the earliest possible opportunity.
“Our alliance with ProcessClaims will help insurers detect potential claims fraud early in the claims process, streamline the auto physical-damage claims workflow and improve loss ratios for customers,” Vincent Cialdella, vice president of ISO ClaimSearch®, said.
ISO ClaimSearch is the property/casualty industry’s comprehensive fraud-fighting resource and the repository of bodily injury, property damage and automobile claims histories.
ClaimDirector provides insurers a claim score immediately upon receiving a claim. ClaimDirector-APD evaluates the number and type of auto claims previously filed and the characteristics of the incoming claim, applies weights to claims based on frequency and relevance to auto-physical damage, and assigns a score. The score provides claims adjusters a guideline to determine whether a claim should be expeditiously handled for settlement or further investigated before payment is authorized.
“Clearly, insurers gain significant advantage in identifying claims of questionable validity at the earliest possible time,” said David Ferrera, ProcessClaims’s executive vice president of business development. “Using ClaimsPort via a web service connection to ClaimDirector, insurers can quickly identify questionable claims for further investigation. This results in measurable return on insurers’ claims-management investment.”
ProcessClaims’s ClaimsPort material-damage management system automates claims processing by configuring solutions to suit insurers’ specific business requirements. The company’s business process automation focuses on areas of material damage to reduce loss-adjustment expenses, increase efficiencies and improve customer satisfaction. ProcessClaims’s open platform provides seamless connectivity to all partners involved in the claims process.
For more information about the joint ISO-ProcessClaims offering, send an e-mail to firstname.lastname@example.org. For more information on ProcessClaims, send an e-mail to Westley.Koenen@ProcessClaims.com.
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