Insight Claims

Most claims management software available today was initially developed by insurance companies to manage their underwriting risk. Then some smart person in the sales department came up with a brilliant  idea: Why don’t we offer this claims management software to our clients? They will help us to manage our risk and probably even pay us for it!

INSIGHT CMInsight Claims©  was  designed by risk managers not by insurance guys. Insight Claims© allows any business to manage insured or uninsured claims. For insured claims, each one is processed as if would end up in litigation (worst case scenario), and work closer with the third party administrator, the in-house claims department or the insurance carrier claims department to control the total loss cost. Regardless of the type of claim, each investigation is conducted as if the claim would end up in litigation. For example, witnesses’ names are sent via email to HR to avoid “accidental” termination of key witnesses. In addition, the application includes tools for loss estimation, loss development and settlement negotiations.

Insight Claims© allows the risk manager to separate claims where the company is the “claimant” or the “other party” receiving the claim. The application breaks the claims management process into three sections: Investigation, Administration and Litigation; providing screens to enter information in each one. Below is some of the information that can be found in each of these screens:

  1. Investigation
    • Claim date, name, number and description
    • Claim’s possible cause
    • Witness List
    • Claims Details screen: Auto, WC, CGL, Cargo, and others
    • Loss Estimator
  2. Administration
    • Claim Carrier Number
    • Claim’s Action Plan
    • Task List
    • Insurance Policies
    • Loss Development Screen
  3. Litigation
    • Litigation Status
    • Suit Action Plan
    • Task List
    • Deposition Candidates
    • Litigation Calendar to set up email alerts
    • Company Legal Team
    • Other Party Legal Team
    • Claim Negotiations and Settlement Screen

Below is the list of some of the documents that can be uploaded in the documents screen of Insight Claims©:

  1. Investigation
    • Incident/Accident Report
    • Pictures
    • Witnesses statements in written format (pdf) or digital voice recording (wma)
    • Police report
  2. Administration
    • Repair quotes for property damages (auto, buildings, equipment, etc.)
    • Records from hospital, clinics or other medical service providers from injured workers
    • Insurance carrier communication (letters, e-mails, settlement offers, etc.)
    • Billing from service providers
    • Payroll records, job applications and other documents from the injured worker’s file (required by State Workers Compensation law)
  3. Litigation
    • Summons and other initial court documents.
    • Subpoenas
    • Request for Productions
    • Request for Interrogatories
    • Correspondence (letters, e-mails, voice messages, etc.) from/to Plaintiff attorneys
    • Correspondence (letters, e-mails, voice messages, etc.) from/to Defense attorneys
    • Depositions in written format (pdf) or digital voice recording (wma) or in video format (wmv)
    • Settlement offers written or verbal (if recorded).