Self-insurance—also known as self-funding—is an alternative risk transfer strategy used by tens of thousands of employers across the United States to finance workers’ compensation, general liability, and other insurance programs, where expenses are paid as they are incurred as opposed to paying a fixed premium to a traditional insurance company.
If done right, self-insurance provides an employer with the highest degree of flexibility and control and the greatest opportunity for cost savings.
When an incident involving customers or employees is under investigation by your security department, all information is reported and documented in an incident reporting system such as Omnigo’s iTrak. This information must then be quickly and accurately conveyed to your claims department. This manual, double-entry process is inefficient and prone to human error.
Once the initial report of a workers’ compensation claim is filed, all employee indicative information must be acquired and transcribed from your HR system into the claims system. Not only is this a time-consuming task and prone to human entry errors, but it also exposes your company to the risk of employee privacy breaches.
As a self-insurer, you often partner with TPAs, medical networks, and law firms to adjudicate and resolve workers’ compensation and general liability claims. Most legacy or homegrown systems do not have the API capability to seamlessly integrate with your resolution partners, making it challenging to keep your claims systems up to date with adjudication and associated financial information as the resolution partner executes the transactions.
Your insureds expect real-time communication across multiple channels (text, email, chat, phone, video) – corresponding just by snail mail or even email is no longer an option. Unfortunately, most claims insurance technology is outdated and does not support omnichannel communications, leading to frustrated customers and unhappy adjusters.
Our cloud-native data-driven claims management solution makes your claims processing simple and smart.
Our digital claims management solutions (CMS) provide:
Our CMS includes an API-level communication module that support all types of communications including: SMS, mail, voice video calls, and even WhatsApp. All claims-related communication is documented, stored and analyzed automatically.
Our systems flags coverage and liability issues and presents the adjuster with relevant information and investigative steps within the claims system.
The key to effectively negotiating a claim begins with accurate damage assessment. Our CMS includes a digital bodily injury evaluation module to itemize, assess, and aggregate damages.
Based on our advanced data modeling, we enable insurers to monitor your operations and receive actionable insights that will help you make strategic management decisions.
A large self-insurer was using a stand-alone legacy system to oversee and manage their workers’ compensation and general liability claims. An internal audit revealed:
Learn how within 12 months of deploying Five Sigma’s SaaS claims management solution, claims had been successfully insourced with immediate improvement in efficiency, accuracy and resolution.
Browse our blog posts for the latest insights and trends in claims management.
