In Claim Management Best Practices, Claim Management Software, Cloud Computing, Technology


As 2015 comes to an end, we reflect back on predictions made by industry experts back in January. 2015 was deemed to be the year of data and analytics in the insurance industry, and here at ClaimVantage, we have seen this to be true. This trend has been a reoccurring theme in industry discussions and research throughout the year and some insurers have demanded enhanced analytical capability to take advantage of the wealth of information contained in their claim management systems.

This year we have implemented some new product features and enhancements to take recent industry and market trends into account:

1.Analytical capability

After conducting an industry survey to determine potential fraud indicators in the insurance industry, this data was compiled to create default fraud rules to flag particular claims. These rules are fully configurable as each company has specific fraud indicators. Each claim is assigned a fraud score to flag high-risk claims and automate the process for low-risk claims.

2. Industry Benchmarking

ClaimVantage has teamed up with IBI to provide industry benchmarking information for FMLA, short-term disability (STD) claims and long-term disability (LTD) claims.

3. Voluntary Product Claim Management

ClaimVantage now offers a claim management solution for Long-term care and critical illness claims. As the ACA is rolled out by employers, voluntary products are more in demand by insurance carriers and Third-Party Administrators (TPA’s). These new product lines are in addition to existing voluntary products we offer.

4. Mobile Portal Enhancements

Since the introduction of our customer portal, some additional enhancements have been made to improve the offering. In addition to creating absence claims, employees can now create health and life claims through the portal, and enter their expected return to work date, while supervisors can view time summary charts directly through the portal.

These are just a few of the most popular product features and enhancements we have provided to our customers this year. As industry and market trends for 2016 are discussed, we will be sure to incorporate these into our product roadmap for 2016.


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