Insurance Services Office (ISO) Limited, the UK’s leading provider of personal injury claims and anti-fraud insurance services and solutions, has launched new Return to Work tools for ISO Claims Outcome Advisor™ (COA) solution. The Return to Work enhancements provide intelligence on how injuries affect more than 14,000 occupations, enabling insurers to assess wage loss and the impact of injury for employers' liability, public liability and motor liability claims. This will allow for more accurate reserving and ensure claims handlers can proactively manage personal injury claims from the first notice of loss and identify potentially fraudulent claims.
ISO has integrated details of the New Earnings Survey from the Office for National Statistics into COA, so claims handlers can assess the impact of a claim based on the occupation of the claimant. Support for the New Earnings Survey ensures that claims handlers can use COA’s detailed level of information on all of the occupations covered in the New Earnings Survey to generate a recovery profile and make more accurate wage loss estimates. The enhancements provide an‘ "early warning" to indicate’ if the injury is likely to prevent the claimant from returning to work permanently, also enabling claims handlers to spot discrepancies between predicted and actual recovery times to highlight potentially fraudulent claims.
"Effective claims management relies on both in-depth understanding of any injury and occupational details to generate an expected recovery profile of the claimant," said Joe Pendle, Director of Client Services at ISO. "For example, if a claimant had broken an ankle in the workplace, he or she would be able to return to work much earlier if the individual is a banker instead of a postal worker. COA has a detailed understanding of the effect of thousands of injuries on thousands of occupations and the likely outcome in terms of wage loss and recovery profile. This level of intelligence built into the software will help insurers manage claims more consistently and identify potentially large loss of earnings claims that wouldpreviously would have remained unnoticed.
"The Return to Work tools also serve as an additional anti-fraud tool for insurers. If, for example, a claimant had a relatively mild injury, and spent a lot more time off work than expected, the new ISO solution would help highlight that anomaly for further investigation," added Joe Pendle.
About ISO Claims Outcome Advisor™ (COA)
ISO Claims Outcome Advisor™ (COA) solution, is the industry’s first personal injury claims management solution that manages the multiple dimensions of insurance companies’ personal injury claims portfolios. COA understands the severity and recovery implications of over 18,000 medical conditions — including injuries, treatments, complications and pre-existing conditions — and 14,000 occupations. COA helps claims handlers, managers and actuaries manage the unique and complex medical, legal, and occupational issues presented by personal injury claims, and helps ensure appropriate financial arrangements are agreed and implemented. Claims handlers can manage all aspects of a case from first notice of loss to return-to-work plans, rehabilitation and damages.
Insurance Services Office (ISO) Limited is the UK subsidiary of Insurance Services Office, Inc. – the premier source of information, products and services related to property and liability risk. For a broad spectrum of commercial and personal lines of insurance, ISO provides statistical, actuarial, underwriting and claims information analyses; consulting and technical services; policy language; information about specific locations; fraud-identification tools; and data processing. Around the world, ISO serves insurers, reinsurers, agents, brokers, self-insureds, risk managers, insurance regulators and other government agencies. ISO customers in the UK include Zurich Financial Services, Highway and Farraday Underwriting Limited.
For more information please contact:
Mark Strang, ISO
Manuela Whittaker, IBA – PR for ISO