Greg Alling, Senior Director, Casualty Product Management
It's no secret that bodily injury claims are more complex than auto physical damage (APD) claims. The subjective nature of evaluating an injury to the human body is usually more difficult than determining vehicle damage. And while casualty claims make up only a fraction of an insurer’s total claim volume, they still account for nearly half of all claim dollars paid.¹ That's why it’s crucial for insurers to use data-driven insights and advancements in technology to help them improve accuracy and gain efficiencies to simplify and optimize the third-party casualty claims process.
According to CCC's 2024 Q1 Crash Course report, the recent outlook for third-party casualty is a "crystallization of a 'new normal' post-pandemic injury and treatment trends." This includes market trends like increased risky driving behaviors and elevated impact severity, medical care inflation, changing treatment patterns from hospitals and medical providers, an aging population and an aging claim workforce, and an affordability crisis leading to higher numbers of uninsured and underinsured motorists.
These trends require a new approach using data and technology to transform third-party casualty workflows and outcomes. In our latest webinar, CCC industry analysts and experts discussed the benefits of insurers focusing on the following three areas:
From talking with insurers, we know there is a delay in receiving casualty claim information after first notice of loss. But imagine if you had insights into impact severity immediately following an accident. CCC's Impact Dynamics combines accident photos with artificial intelligence to allow adjusters to quickly identify and understand expected injury potential for the occupants of a vehicle.
By scanning submitted vehicle photos from one of CCC's APD solutions, the AI model automatically estimates the range of impact-related change in velocity (measured in miles per hour) within minutes. This valuable information can be applied to a variety of use cases for both first- and third-party claims including: exposure recognition, risk evaluation, triage, identifying potential fraud, reserving, and underwriting. With Impact Dynamics, you gain meaningful insights earlier in the life of the claim so that you can understand the potential for bodily injury quickly and make better-informed decisions on next steps.
According to a recent study by J.D. Power, digital communications channels are key to maintaining customer satisfaction throughout the claims process, but many insurers are failing to deliver a truly seamless digital experience. CCC's Third Party Digital Portal is a mobile consumer experience that helps insurers deliver seamless customer interactions and creates a self-service channel for third-party casualty claim information. Claimants provide information and supporting documentation about their claim, and the adjuster can review, evaluate, and present a settlement offer all within the portal. This tool minimizes adjuster touch points for low-complexity injury claims accelerating the settlement process and providing the digital interaction that many policyholders now prefer.
Beyond the digital portal, insurers need a one-stop shop to assess medical bill accuracy, expedite claims processing, identify anomalies, and standardize decisions with an integrated set of solutions. In our latest webinar, former bodily injury adjuster Tim Rowe recalled how he felt when the mailroom cart dropped off 1,000-page demand packages to review. "I knew that the next six hours of my day would be spent meticulously combing through those documents, and I wish I had tools available to make that an easier process," he said.
CCC's Injury Evaluation Solutions (IES) platform eliminates many of these time-consuming manual tasks so adjusters can focus on the core evaluation and negotiation activities that truly impact claims outcomes. Within IES, medical bills, medical reports, and demand packages are ingested, digitized, and organized in a meaningful way for easier review. The analyzer links medical bills to reports, removes duplicate and prior date of loss bills, completes a bill audit summary with edits and flags, provides an automatic treatment calendar, and offers configurable state-specific benchmarking tools such as Medicare, FAIR Health, or Fee Schedule.
Some bills require additional medical expertise to help adjusters determine causation and injury relatedness. Our targeted algorithm is configurable to flag the most impactful demands for additional expert review. CCC’s integration with Tempus enables bills to be auto-referred for collateral source validation and direct-to-provider negotiations all in a single platform without the need to use multiple applications. Referral results are returned to IES where adjusters can easily apply adjustments and finalize an evaluation. Using the tools available in IES helps insurers streamline administrative processes and achieve claims consistency.
CCC’s third-party casualty solutions simplify and optimize the claims process using innovative photo AI, an easy-to-use digital portal, and a comprehensive medical bill review platform that covers all corners of the claim lifecycle. In addition to digitizing the claims process, CCC is known for its personalized approach to helping insurers achieve company objectives. Our highly skilled teams have over 200 years of casualty industry experience to help drive results through executive business reviews and consulting studies, process and workflow reviews, in-person trainings and Q&A sessions, and leading industry insights. By partnering with our customers, we help insurers uncover business opportunities, streamline processes, and improve productivity.
Want to learn more, or have specific questions about how CCC's third-party casualty solutions can help your business? Click here to schedule a quick call with your account manager.
