Dynamic Claim Summaries: Smarter, Targeted Insights for Claims Adjusters
By Pragatee Dhakal
Dynamic Claim Summaries are a powerful new feature designed to streamline the claims review process by providing AI-generated, focused summary views that go beyond the standard top-level summary. Built with the needs of adjusters in mind, Dynamic Claim Summaries make it faster and easier to extract relevant medical insights from complex documentation. With four distinct summaries available through a simple dropdown interface, users can quickly toggle between high-level overviews and targeted deep dives—all within the same workspace, eliminating the need to sift through lengthy reports or multiple documents.
The Overall Summary offers a high-level snapshot across four critical domains: Initial Injury, Ongoing Medical Care, Additional Care Considerations, and Prior Injuries & Surgeries. For more specific information, the Initial Injury Information view focuses on the early stages of the claim, detailing the nature and cause of the injury, initial complaints, diagnoses, and any emergency interventions provided. The Ongoing Medical Care summary captures a comprehensive treatment history, including surgeries, prescribed medications, complications, and follow-up evaluations, helping adjusters understand the full course of medical care.
The Additional Care Considerations view highlights critical but often overlooked elements such as specialist consultations, disability assessments, mortality reports (if applicable), and post-treatment monitoring. These insights are essential for evaluating long-term care needs or potential claim complications. Finally, the Prior Injuries & Surgeries summary surfaces any comorbidities or past procedures that could influence the claimant’s current treatment plan, outcomes, or eligibility.
By delivering concise, targeted information in an intuitive format, Dynamic Claim Summaries empower adjusters to make informed decisions more efficiently. It transforms how medical summaries are reviewed—offering clarity, speed, and precision in every claim. Whether reviewing a new case or revisiting an ongoing file, Dynamic Claim Summaries ensure that the most relevant information is always just a click away.
