workers comp claims management software

Workers Comp Claims Management Software

With Native AI

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Why KlearClaims as your Workers Comp Claims Management Software?

THE FUTURE OF CLAIMS ADMINISTRATION IS HERE  - KlearClaims™ - Our SaaS-based workers comp claims management software with intuitive Native AI POWER! 

workers comp claims management software for automating claims

Automation

Enhance Efficiency through Automation of Claims Handling with AI-powered Workers Comp Claims Management Software: KlearClaims

workers comp claims management software using NATIVE AI

Artificial Intelligence

Leverage cutting edge AI to identify claims which need immediate attention; Enable the system to recommend claims administration

workers comp claims management software for collaboration

Collaboration

Extend the claims handling program by seamlessly integrating multiple teams into the workflow

workers comp claims management software for performance management

Performance Management

​Objectively quantify the accuracy of examiners, the contribution of auditors, and the ROI of the claims handling program to your organisation.

It’s more than just a Workers Comp Claims Management Software—

it’s peace of mind

KlearClaims Ecosystem

KlearClaims: A SaaS workers comp claims management software with native AI. #1 rated workers comp claims management software with AI modeling powering robust Predictive Analytics, Intake, and Automated Auditing functionality.  

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AI integration with workers comp claims management software supports Your Claims Handling! 

- Adjuster -

Native AI analytics help adjuster predict claim's severity, litigation & subrogation propensity and reserves, all within the claim system

 

- Supervisor -

AI integrated dashboard unique to each claim summarizes claim's critical activities for quick claim assessments 

 

- Executive -    

Automate claim workload distribution by having multiple employees work on a single claim based on their role ( Role Based Automation )

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Configurable Client Handling Instructions

- Adjuster - 

Automated client handling instructions ( CHI ) for each claim saves adjuster's time handling multiple clients

 

- Supervisor - 

Focus on task’s based on priority for real-time transparency

 

- Executive - 

Highly configurable and customizable unique UI for Clients, Carriers, Line of Business, Claim Type, Jurisdiction and Organization

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Smart, Situational Compliance Automation


- Adjuster -

Distinguished, unique interfaces for Workers' Comp and Liability optimize claims management workflow

 

- Supervisor -

Automate audit plans “powered with AI” customizable based on client, carrier and state regulations to highlight claims handling performance

 

- Executive -

Real-time pre-validated compliance submissions and carrier reporting to avoid late fees and penalties

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Frequently asked questions

As a KlearClaims™ prospect, what does native AI mean for me?


Helps better utilization of Claim Adjudicator team’s time & significant improvement in overall process efficiencies:

  • Using a native AI powered Claim’s system helps adjudicators on many decision-making points like
    1. Claim Severity,
    2. Reserves,
    3. Potential fraud,
    4. Subrogation opportunities
    5. Litigation propensity and
    6. Many more
  • The outputs from Klear.ai Predictive Systems are visible on the transactions screens within KlearClaim™ saving the effort and time to switch between two or three different systems.




What type of business entities would derive great value from your solution/products?


Any Property & Casualty (P & C) Insurance related business including Insurance Third Party Administrators (TPAs), Self-insured and self-administered public & private entities, Insurance pools/ Joint Power Authorities (JPAs), Insurance carriers and professional services audit, legal and investigative firms in the space of Workers Compensation Insurance would be able to derive significant values from KlearClaims System.




How is your solution/product different from other competing solutions in the market?


Ours is the only fully integrated end to end solution in the space of Insurance Claims and Risk Management, powered by native AI models.

Our solution includes the following components:

  • Claim Intake – KlearIntake™
  • Claim Adjudication - KlearClaims™
  • Internal Claim Audit that helps to clear all types of external audits without any negative points audit remarks - KlearAudit™
  • Claim Analytics - KlearAnalytics™
    • Claim Severity
    • Prediction of Reserves
    • Subrogation opportunities
    • Detection of Fraud at a very early stage
    • Litigation propensity and
    • Many deeper insights from both internal and external data

Our solution is designed and developed by the Insurance & Technology industry veterans, who have experienced challenges of various teams in the P & C insurance space with the following objectives:

  • Our solution should be very user friendly.
  • Our solution should enable and empower our customers to serve their clients better
  • Our solution should be solution of tomorrow but available today

And finally, in addition to rich features and functionalities,

our solution is backed by impeccable customer centric & employee centric management team for post implementation support – our customers need not address any challenges on the support front and that would enable them to focus on their business and empower them to enhance their customer experience.




Can we get some components of your integrated solution, or do we need to have all?


Yes, certainly you can buy some components or any one component independently. However, for optimal Return on Investment (ROI) we strongly recommend going in for our total integrated solution.




Do you provide user training?


Yes, we do provide user training.




Do we need additional IT infrastructure like Hardware and Software to use your solution?


No need, our solution is hosted in a secure Microsoft cloud environment, and we will provide you secured role-based organization-based access.





13 reasons why KlearClaims will Future-Proof your workers comp claims management software

 

 

1 - Fully integrated system where users can view the AI and ML predictions within the claim screens.

2 - Completely automated rules - auto-generation of correspondence, texting, carrier reporting, based on clients and jurisdiction all the way down to the organization level

3 - One system that can audit all claims continuously for compliance and best practices. Workers comp claims management software KlearClaims is built with Native AI. # 1 rated AI-powered workers comp claims management software with end-to-end solutions. 

4 - Real-time pre-validated State and Federal Compliance Submissions

5 -Role-based system to assign multiple privileges on a claim e.g., having a junior examiner and an overseeing trainer examiner on a single claim

6 - (AI) integrated Dynamic Dashboard for Claim status  

7- Priority and Event-based Task monitoring for efficient execution and workflow

8 - Incorporates Automated Business Rules into Case Management and Claim Activity

9 - Decreasing Adjusters’ efforts in handling Complex Multiple Client Handling Instructions

10 - Avoiding Late submissions to Carriers for non-acceptance of Claims

11 - Avoiding penalties regarding late/non-submission of statutory information ( CMS, FROI/SROI, etc.)

12 - Automation and Redirection to UR for Treatment Request. Providing suggestions for non-medical requests based on individual Client specifications

13 - SMART KPIs  – for example, "Providing Provider recommendations based on injury details and Claimant location"