In any claims operation there is a tendency to review the complete claims process when companies think about system replacement. This can be a daunting process in terms of time, money and resources. According to the recent claim survey sponsored by ClaimVantage this is one of the reasons insurance carriers keep pushing out the inevitable and keep patching up the existing claims management system.

STD claims are less complex than LTD claims as they have defined durations of up to six months. Over 90% of cases are completed and paid before they are transferred to the LTD claims process. To implement an STD claim management system there is no need to do a data conversion as most claims will be completed in the initial six month period.

The STD process requires an intake and assignment process that can be either manual and/or automatic, using the Reed Group Medical Disability Advisory. Intake can be fed from other systems including Family and Medical Leave (FML) systems or census data provided by the employer. Some of the STD claims can be auto-adjudicated based on claim type and complexity. This provides significant savings in terms of resources and time. Customer satisfaction is increased considerably as claims are adjudicated in a very efficient manner.

The ClaimVantage strategy is to deliver claims management systems in an ad-hoc manner that works for the customer. In the case of STD claims systems, ClaimVantage can deliver a production system in a 90-day timeframe. The objective is to provide a proof of concept STD claims system within a 30-day timeframe that can be configured and tested in-house before going into production

ClaimVantage can deliver this level of functionality using the JBoss Rules and Workflow products integrated into ClaimView and ClaimPay supported by a repository of rules and workflow processes that support best business practices.

The benefit of this approach is to deliver a project within a short timeframe that can be evaluated in terms of cost and return on investment. This approach also provides a basis to deliver the more difficult group LTD system that requires additional integration points, configuration and data conversion over a longer time period.