Automated predictive analytics

Nodal Claims Triage

Optimize claims performance, identify at-risk claims, and reduce cost

The challenge

Effective claims processing is more important—and more challenging—than ever

Rising medical, indemnity, and legal costs make it critical to identify and manage high-cost claims as early as possible. At the same time, the claims adjustment workforce is losing large numbers of experienced workers to retirement. Insurers need a way to improve claims triage and the employee experience while bridging the knowledge gap.

The solution

Use AI to predict and manage volatile claims

Nodal® Claims Triage helps insurers and large employers reduce claims severity by enabling them to identify problematic claims early and apply cost-mitigation strategies when they are most effective. Using a wide variety of structured and unstructured data, our predictive models help you triage claims and monitor results post-implementation. Allocate resources efficiently, identify the likelihood of litigation, estimate how long the claim will stay open, and more.

BENEFITS

Nodal Claims Triage benefits

Maximize the value of claims professionals

Help your team expedite low-cost simple claims, predict at-risk high-cost claims, and identify claims that are likely to escalate in cost early more independently, with less oversight from senior staff. Nodal empowers even less-experienced adjusters to quickly identify high-cost claims shortly after First Notice of Loss (FNOL).

See measurable results

Track your team’s success with Nodal Claims Triage when you review the built-in quarterly performance report. It summarizes claims scored to-date with specific focus on model accuracy and ROI.

Increase consistency for future claims

Budget and reserve with greater confidence thanks to predictive capabilities that enable volatility management.

Trust built-in expertise

Rely on a comprehensive approach that incorporates decades of industry experience with claims operations and actuarial science.

FEATURES

Nodal Claims Triage features

Predictive Analytics

Organize unstructured data with powerful technology that will in turn predict volatile and high-cost claims by extracting information from adjuster notes shortly after the claim is reported.

Flexible AI

Quickly identify insurance claims trends and transfer problematic claims early with dynamic data visualization tools. Gain new insights from interacting with the data – use it as a training tool for less experienced members of the team.

Tailored Solution

Meet your specific business needs with a comprehensive model that comes ready to deploy. Nodal Claims Triage is not an out-of-the box solution. Our team constructs models based on each client’s own detailed claim, medical, and text data while leveraging Nodal’s database as support.

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