De-Stress Medical Claims? You Need a Smoother Online Engine

One sticking point with medical and health claims can be the dreaded paperwork; endless pages of questions, technical terms and definitions that can be baffling for customers, plus gathering up evidence of financial hardship or loss perhaps. If insurers can streamline the process, then there is a saving of time on both sides, plus a reputational benefit for the insurer when claims are sorted out quicker.

The SCOR Claims Rules Engine (CRE) is a flexible digital claims management solution tailored to the claims needs of insurers and the evolving expectations of their customers. By accelerating claims lodgment and decision making, the SCOR CRE frees up claims assessors  to better support customers with more complex claims.

At the cutting edge of medical knowledge and actuarial excellence, the SCOR CRE is the perfect digital claims solution to enhance customer service, reduce costs, and improve claims outcomes.

“We developed the CRE to provide both time and cost savings for insurers in a process that can otherwise be highly labor intensive”, said Brona Magee, Deputy Chief Executive Officer of SCOR Global Life“We wanted to digitalize claims procedures to improve the user experience for insurers and claimants alike.” 

The CRE leverages Smart Rules to create consistency for the customer at the earliest stage of the claim notification. Using behavioural economics principles, the base questions are easy to understand, instinctive, and free of medical jargon. For customers, this translates into a simple claims-lodging process that is also free of paper forms. Shorter end-to-end processing times lead to faster payments on standard claims and increased support on more complex ones.

The CRE’s simplified customer question set is backed by a robust, comprehensive ‘Smart Catalogue’, containing thousands of medical conditions and symptoms that drive decision outcomes for insurers across multiple products. This facilitates accurate triaging of claims, identification of claims requiring early intervention, and support for claims managers in setting initial and ongoing claims strategies.

Application Programming Interfaces (APIs) built into the SCOR CRE accept known data from an existing policy administration system and feed the output into an insurer’s Claims Management system. The insurer’s data-entry time is therefore greatly reduced, if not fully eliminated, and accuracy is greatly improved. Moreover, the digitized data collected in the claims lodging process, combined with other digital data resources, provides a wealth of information that can be analyzed and leveraged for multiple purposes, including pricing decisions, new product offers, and so on.

“As reinsurers, we understand the difficulties faced by our insurer customers as they strive to provide the best claims journey for their customers”, said Brona Magee, Deputy Chief Executive Officer of SCOR Global Life“The SCOR CRE was purpose-built with the goal of driving customer satisfaction. It’s clear that when a customer needs to make a claim, it is a stressful and difficult time in their lives, and the claims notification process can be overwhelming. Providing insurers with a fully digital, efficiency-driving solution will help them to improve the claims path for their customers.”


About alastair walker 11433 Articles
20 years experience as a journalist and magazine editor. I'm your contact for press releases, events, news and commercial opportunities at Insurance-Edge.Net

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