Context

One of the biggest costs in auto insurance is Personal Injury (PI) Claims - around 28% of total UK motor insurance costs (Source ABI). Whilst UK Road Traffic Accidents have declined by 35% since 2004, PI Claims have risen by 40%. On top of that Claims Management Companies (CMCs) and lawyers more aggressively target customers to maximise claims. There are more than 750 CMCs in the UK alone and since 2017 the Claims Management Regulator has cancelled 69 licenses -an indication of poor standards and ethics by a significant minority.

One result is that insurers find it increasingly difficult to calculate adequate reserves. During the lifetime of a claim the prognosis changes constantly and as a result the insurer often under-reserves impacting the business adversely.

One key reason for this is the vast amount of unstructured data hidden in letters, emails, medical reports, MoJ documents and rehabilitation reports. We have found that typically more than 80% of an insurer’s data is locked away and inaccessible. Insurers find it a significant challenge to access the data and make it available for analysis. Add to this it changes constantly as medical specialists and claimant’s solicitors change the prognosis. It is hard enough to keep track of bona fide PI claims never mind fraudulent ones. This all results in key challenges insurers must overcome.

Challenges facing PI Insurers

Poor claims control over the entire claims lifecycle

  • Under-reserving
  • Not flagging complex claims for early intervention
  • Unable to identify trends and patterns
  • Analytics tools complex and inflexible

Current PI management tools lack actionable insights

  • Claims files largely unreadable- relies on manual analysis
  • Difficulty reading source data in multiple formats and data silos
  • Lack of real-time alerts, prioritisation and effective decision making
  • Ties insurers’ hands behind backs dealing with aggressive CMS and Lawyers

This calls for an innovative Personal Injury Analyser (PIA).

360PIA - the solution

360Globalnet’s solution to the challenges above is 360PIA, which utilises 360Globalnet’s proprietary unstructured data technology to access, join and analyse multiple and disparate data sources. It has been customised to tackle the PI Claims Challenge. How?

Digitally Transform PI Claims

  • Access and interrogate Unstructured Data
  • Read Data at Source
  • Real-time BI/MI to manage PI Claims
  • Embed and link characteristics in weighted business rules
  • Automated 24/7 watch on all PI Claims flagging green, amber and red for the potential large loss and incubated claims to the PI Team
  • Combine optimal mix of automation with human intuition

Profile PI Claims

  • Creates Injury Matrix- Categorises injury types including multiple conditions
  • Link structured & unstructured data to analyse occupation, vulnerable road users, injury type, periods off work, prognosis etc
  • Identifies characteristics under-reserved claims or claims that have bigger potential than human handlers realise
  • Apply new business rules to focus attention on right & timely decisions
  • Significantly improve reserving
  • Analyses prognosis changes in real-time for timely response

Profile Lawyers and CMCs

  • Nature and types of claims they pursue
  • Break down into heads of claim categories
  • Flag outliers and anticipate abnormal behaviour
  • Identify those gaming the system
  • Anticipate tactical changes ahead of legal reform e.g. whiplash
  • Analyse changes at individual lawyer level

The result is to know the (currently) unknown and combine that with the known for better decision-making and better customer service. You will combine customer satisfaction with greater efficiency. You will combine technology with human intuition and empathy, so customers feel respected and looked after. You will avoid under-reserving and you will have a defence against aggressive CMCs and PI lawyers.

You might be used to such solutions taking a year or more to deploy and requiring a significant investment. Think again with deployment in months and a subscription pricing model that pays for itself.

Challenge your team and start a three-month POC that prove the cost-effectiveness of 360PIA.

Contact Jason Claxton or Jason Peto, our PI and Fraud Specialists, at:

Jason.Claxton@360Globalnet.com

Jason.Peto@360Globalnet.com