Claims litigation dashboard

Case study

Claims litigation dashboard

According to the 2019 CLM Litigation Management Study, 50% of respondents (insurers) have reported an increase in per-file litigation costs and 43% of them reported higher litigation inventory levels. Even though major legislative reforms have been implemented to reduce complexities and expenses in the insurance industry, claims related litigation continues to increase.

Insurance companies are now looking to invest in claims related technology and advanced analytics to reduce the impact of litigation costs on their revenue. Technology can be used early in the claims process to identify at-risk claims and also leverage historical data to strategically plan for the future.

Our client drives change in the commercial insurance markets with easy-to-use digital solutions. These solutions substantially reduce claim costs by foreseeing client needs and aligning them with the best possible resources.

Requirements

The idea was to build a claim management solution built around their analytics engine with the following modules:

  • Claims analytics to identify at-risk claims, prior to escalation.
  • Litigation engine to minimize and manage the impact of litigation.

Challenges

The solution had to be based on the client’s proprietary core analytics engine and delivered on a SaaS platform. Some of the key challenges include:

  • Processing huge volumes of data and storing billions of records
  • Lack of customer-level customization options to drive analytics
  • Low latency leading to poor performance in loading times

Solution

We proposed to come up with two modules: Claims dashboard and Litigation dashboard. Our client’s data source is a CSV file that holds the claims information, which could be uploaded on a daily basis through SFTP.

To enable alerts setup, we designed the database to hold the captured field elements from the CSV file and perform elastic search on them. This is to make sure that our client’s customers can set up their own custom alerts and complexity-level thresholds. These alerts can help in identifying claims that needs to be settled at an early stage and also prevent claims that could potentially lead to litigation.

The simple UI/UX flow would make it easy for users to visualize and generate reports on crucial metrics easily. The claims dashboard can display multiple types of visualization charts with open claims on the risk index, adjuster wise claims, and location based claims count. Whereas, the litigation dashboard can display attorney expenses, average cost, average handling time, and much more.

These dashboards help clients to monitor the claims and identify at-risk claims, before they are escalated. It also helps track the performance of attorneys, manage litigation, and reduce costs. The dashboard design offers snippet view or full view of the analyzer tab. The results can also be exported as reports.

Tech stack

How our solution helped

Scalable engine capable of searching billions of records in less than 60 seconds and raise critical alerts.

Overall approach

We came up with a multi-tenancy architecture driven solution. The architecture helped to separate customer data, enable high-level customization, and master dataset versioning. Elastic search was used to process large volumes of data and present the results through the UI.

Results

  • Improved performance of the application with quick loading of pages
  • Generation of customer alerts on claims and predictions for litigation avoidance.
  • Early claim settlement alerts to save both money and time.
  • Best-rated attorney suggestions on the basis of the type and risk index of each escalating claim
  • Intuitive and user-friendly dashboards and charts
  • HIPAA compliant data security and privacy

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