The Jane and Richard Saga: Triaging Commercial Auto Claims with a Claim Navigation System
She is a commercial auto casualty claim adjuster for Occidental, a large commercial insurer. Her job keeps her very busy, but that’s something she enjoys. Jane typically has 75-150 open claims that she is responsible for handling. But, she occasionally gets overwhelmed by the volume of claims, especially when the proportion of complex claims on her virtual desk gets out of hand.
Mondays are usually her most challenging days. That’s when the flow of new claims is highest. Other days can be difficult, too, like last Tuesday when she inherited 40 new (to her) claims from another adjuster who had just quit. The trouble is that every day now seems like a Monday or last Tuesday. Jane’s mantra has become, “I wish there were a GPS navigation system for claims!”
She needs it to prioritize her open claims, deciding which needs her attention right now and which are on the right track. Jane always has her navigation system running in her car, even for routine trips, because it can alert her when there’s trouble in her path. If she designed a navigation system for claims, it would always work in the background, processing new information when it comes in and alerting her to potential hazards ahead that can derail a claim on a “straight-through” path.
But when a claim is complicated, the next best steps for her to take aren’t always clear. For instance, if a large truck plows into a line of stopped cars, the injuries can be many and some severe. Who is accountable for all the injured parties can be a nightmare. Navigating through the injuries, multiple parties, many medical providers, and the potential for attorneys to get involved would challenge the most experienced adjuster. The system Jane has in mind would be a big help in these situations, advising her, augmenting her intelligence if you will, on what steps to take to assure the injured parties, policyholder, and insurance company all experience positive outcomes.
CLARA’s Triage product is what Jane needs.
Jane has heard of CLARA before. Her former colleague, Richard, moved to a company that uses it. He has sung its praises to Jane, mostly at conferences they attend. Richard mentioned a month ago how CLARA’s Triage acts as a second set of eyes to catch and analyze crucial information before he has a chance to. It also alerts him when vital and out-of-pattern data comes in overnight, focusing his attention on claims that need intervention first thing in the morning.
Richard thinks of CLARA as the company that makes him smarter. CLARA Triage doesn’t do his job for him; it augments his skills and capacity to make better decisions faster. Triage employs artificial intelligence to model the best action to take on a claim. Still, it delivers it to him intuitively, in an easy-to-understand manner.
Richard was a highly respected adjuster at Occidental. Jane is sure she can get her leadership engaged in looking at CLARA based solely on Richard’s recommendation. She picks up the phone and calls Richard.