Process and manage claims fast and efficiently

More efficient claims processing and management has become a key initiative for insurers, both to control costs and to increase customer satisfaction. FICO helps insurers automate claims intake, set more accurate reserves, make better claims decisions, reduce turnaround time, and cut operating costs. Insurers can employ business rules to their best advantage, adding quick "red flags" and applying them to in-coming claims or guiding claims assessors to collect only the relevant information at the first notice of loss. These rules can be used to perform extra checks to detect fraud, as well as to reduce time and cut operating costs. Insurers can also leverage our claim-level analytics-based solution to accurately and efficiently make claims reserving decisions.

FICO insurers have achieved significant improvements in claims management:

• Reduce the number of calls from an average of 8 to an average of one call to get the right data from customers
• Manage 50% of the claims through a triage system with no referral needed to a claims assessor
• Boost the number of exceptional claims identified for workers compensation insurers from an industry average of around 20% up to 60%

With FICO’s claims processing and management solution, you can:

• Auto-adjudicate acceptable claims.
• Equip claims assessors with the ability to collect only relevant information at first notice of loss.
• Route claims needing further review to the appropriate investigative professional.
• Identify fraud as early in the process as possible.
• Achieve more efficient reserving by estimating it at the claims level.