Casentric Articles

Controlling Medical Costs

February 9th, 2016// By: CaseXpert

If food prices rose as fast as healthcare over the past 70 years, you'd be paying $55 for a dozen eggs. Medical cost inflation has had a significant impact on the cost of settling personal injury claims. Understanding how to contain them is critical to managing your average cost of settlement. We recently recorded highlights from a webinar we delivered on medical cost containment. This webinar covers the dramatic impact of healthcare costs on bodily...

[caption id="attachment_621" align="alignleft" width="200"] Sometimes treatment doesn't get anywhere...should you pay?[/caption] Individuals making claims for personal injuries regularly support their claims with medical records which show significant levels of treatment that produce little to no improvement. How many times would you go to a doctor if you said your pain was 7-8 on a scale of 10 and you weren't getting any better? Put another way, how many times would you take...

What makes your best performers the best?

January 25th, 2016// By: CaseXpert

The insurance industry is full of individuals who are "experienced" and have been at it a long time. I've been at it 28 years. I've managed many adjusters  in a variety of claims - from very simple to those with mind-boggling complexity. Some adjusters performed very well - at an expert level....others not so much. So just what does make someone at expert in claims? A top performer? Some research on the...

CaseXpert™ Adjuster Scorecard

March 20th, 2015// By: CaseXpert

“You cannot manage what you cannot measure.” – Peter Drucker When we ask adjusters about information they use in claims evaluations, we often hear about such things as vehicle damage, scene layout, treatment note analysis, medical bill reductions, etc. However, file reviews tell us that such information is not, in fact, routinely considered in their evaluations and that what they use varies considerably from adjuster to adjuster. To achieve qualitative...

Negotiation Starts at the Investigation

March 20th, 2015// By: CaseXpert

Negotiation is a weak spot in claims resolution. No one trains it anymore. Many adjusters claim proficiency or better because they have been doing it a long time. We work a lot with negotiating and we see the impact it has on effective resolution. Most people would agree that poor investigations lead to poor evaluations which lead to poor negotiations. Poor investigations are short on the facts and evidence that...

Article by Jim Kaiser in Claims Management Magazine Claims system replacement is on the agenda of many insurance leaders. Systems now available in the market offer considerably more functionality than legacy solutions. As carriers evaluate systems, they should keep in mind how these capabilities can impact improvement in performance. Once you have decided to start looking for a new system, it’s time to start thinking about how new functionalities can...

Creating Connections

July 29th, 2013// By: CaseXpert

Management of data is one of the main impediments to the timely and accurate evaluation and resolution of liability and injury claims. How information is collected and used to construct the value of such cases doesn’t resemble the orderly format of a property damage estimate or a medical bill and, yet, we rely upon our technology to assess value. To do this with any reliability, however, technology must satisfy three...

Article by Jim Kaiser in PropertyCasualty360.com The use of data to gain deeper insight into claims performance is growing rapidly. Technology and tighter process management is fueling this growth. Legacy system replacement provides offers the opportunity to collect more data as do other solutions such as medical bill review, auto and property damage estimating or injury and liability evaluations. Business intelligence systems designed to improve our ability to consolidate and...

In the U.S. P&C industry, claims processes remain fundamentally inefficient and there is a $36 billion opportunity to reduce claims-loss costs and expenses, according to “10 Startups Transforming P&C Claims: A US$36 Billion Opportunity,” a report from Aite Group. “Claims operations are still extremely labor-intensive, heavily paper-based, and data-rich but information-poor,” said Stephen Applebaum, author and senior analyst at Aite Group in the report. “As visionary P&C insurers reinvent themselves...

Casentric, which builds intelligent software solutions that create competitive advantages for property casualty insurance claim operations, has retained CLM Advisors to assist in the market expansion of CaseXpert™, an innovative solution for the Property and Casualty industry. CaseXpert™ helps adjusters effectively investigate, evaluate and negotiate the damage and liability components of property and casualty claims. “Having completed a successful pilot phase of CaseXpert™ in the P&C market, we wanted a...