ISO equips claims handlers with medical expertise

• Medical encyclopedia launched for Claims Outcome Advisor to provide personal injury claims handlers with online medical information
• Enables claims handlers to interpret medical reports, accurately enter data into claims system and negotiate with solicitors for fair and equitable settlements

Insurance Services Office (ISO) Limited has launched a medical encyclopedia module for its Claims Outcome Advisor (COA) personal injury claims solution. The new module will provide claims handlers with comprehensive online medical information - including anatomical diagrams and illustrations - and details of complications, treatments and pre-existing conditions previously only easily accessible by medical professionals. This will help claims handlers to interpret medical reports accurately, enter and manage the data with COA, and negotiate with solicitors for fair and equitable settlements.

The new medical encyclopedia module follows the recent announcement from ISO calling for the insurance industry to adopt the international medical ICD (International Classification of Diseases) standards for claims management. Users of other systems often enter ‘dumbed down’ versions of the information made available by doctors onto their claims administration system. This reduces the value of the data and increases the potential for discrepancies in claim offers. Insurers that use these standards would be able to interpret this medical information more accurately with the COA encyclopedia to make more consistent and accurate claims offers and help to reduce spiralling claims costs experienced by many insurers.

"It is critical for claims handlers to have access to and understanding of medical issues if they are to handle claims efficiently and fairly," said Lee Fogle, Head of ISO’s COA division. "From our research with our customers, one of the most important areas to combat rising personal injuries claims costs, is to empower the claims handler with more information about similar claims and injuries. One of the advantages of COA has always been that instead of coming up with a claim settlement offer based upon their personal experience, claims handlers have access to all of the claims settled by their company at their fingertips. Now, the claims handler has even more information about injuries and conditions with diagrams and illustrations to understand the injury in more detail.

"This all means that claims handlers can make a more accurate offer. Offers that are too low are more likely to go to court and end up with huge legal fees. Offers that are too high represent pure leakage. Getting the claim settled fairly and equitably as quickly as possible is in everyone’s interest, and arming the claims handler with more medical information can only help this process," Lee Fogle added.

About Claims Outcome Advisor™ (COA)
ISO’s Claims Outcome Advisor™ (COA) is the industry’s first personal injury claims management solution that manages the multiple dimensions of insurance companies’ personal injury claims portfolios. Using internationally recognised ICD medical codes, COA understands the severity and recovery implications of over 20,000 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.

About ISO
Insurance Services Office Limited (ISO) 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 and 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 the Admiral Group, Axa, Chaucer Insurance, Highway Insurance and Zurich Financial Services. For more information on ISO products, contact ISO at Info.uk@iso.com, or visit ISO at www.iso.com.

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