Individual disability claims are pro-actively managed from the initial claim submission. This is due to the complexity of the claim, the long elimination periods and the potential riders associated with the policy plan.

When an individual claim arrives at intake, it is critical to understand the policy plan detail as it can vary considerably based on the amount insured, and/or the riders involved. Due to the individual nature of the policy, the Claim Analyst needs to see product plan details including elimination period, individual riders and waiver of premium if applicable. In order to be able to access this information, an integration point is required between the policy administration system and the claim management system. Relevant data is downloaded to the claim system so that the Claim Analyst has visibility of the policy plan. ClaimVantage provides this view of the policy detail using the Policy Integration Layer™ to store and maintain policy data in the claim system.

In managing the individual claim there may be a need to share information between a number of resources including Nurses, Doctors, Rehabilitation Services, etc. To do this takes time as the file is copied and passed to the various individuals who are party to the decision process. In a recent claim survey sponsored by ClaimVantage it was clear that sharing the file online between the various parties in the decision process was critical to speeding up the decision and imaging was a key component to solving this dilemma.

The claim survey identified individual disability insurance carriers as leaders in the implementation of image technology. ClaimVantage understands the importance of image technology and support imaging as part of the product suite.

In any claim it is important that the correct amount of disability is paid and that any associated riders are also paid as part of the payment schedule, this may include a Critical Illness rider, Hospital Cash, Cancer, etc. ClaimVantage recognizes this requirement and support multiple benefit options per payment so that one check can be sent to the claimant with an explanation of benefits (EOB) statement.

ClaimVantage understands that Individual Disability claims are complex and need a very flexible approach to rules and workflow processes. To deliver this level of flexibility, ClaimVantage has integrated the JBoss rules and workflow engine so that you can control your work processes, meet your customers expectations and react to market changes in product plans.