Advantage

Expert Service Quality

We are a boutique injury claim company, guaranteeing that your injury claims are only handled by experienced experts. With over 35 years of executive experience in both strategic and operational claim management, inHEALTH approaches each claim with a level of professionalism, knowledge, and care that can only be found in a niche organization.

ADR Settlement Expertise

Ongoing disputes are expensive and time consuming, impeding operational success. inHEALTH's specialized settlement and ADR experts have a proven track record of professional and efficient dispute resolution. Putting the right skillset to the right task reduces the overall expense cost to the claim; with our strategic experts, you do not have to choose between quality and cost-efficiency. Our team has the experience and knowledge to recognize opportunities for resolution and perform comprehensive risk assessments.

Our track record*:

  • 86% settlement rate of outstanding accident benefit files in the dispute process
  • 57 day turnaround on files with a Summary Settlement Report including an analysis and rationale for settlement result and final release
  • Opportunity for savings of over $10 million in FSCO levies and litigation fees**

*Based on handling over 1200 AB claims.
**Assuming an average of $10,000 in defence legal fees per claim

Proactive Claim Management

We deliver proactive claim management by shifting you away from process toward risk-based analysis and approvals. We base approval decisions on individual claimant recovery and rehabilitation needs that are assessed early in the claim process. Using the individual's recovery as a baseline ultimately reduces the claim lifecycle. This strategy allows adjusters to take an active approach with healthcare providers and a more timely use of third party involvement such as IE's.

Results of proactive claim management on an average claim lifecycle:

  • Efficient resource allocation through separation of high /low risk claims
  • Reduction of treatment and assessment requests
  • Accurate allocation of medical rehabilitation funds
  • Refocuses adjusters' time
  • Reduction of claim expenses

Three Avenues for Knowledge-Transfer

Our team is passionate about the insurance industry and the development of professionals within it. We have intelligently streamlined the claims process, and distilled that knowledge into best-practices, management models, analytic metrics, proprietary tools, and reporting mechanisms. When you partner with inHEALTH through any of our three service areas - adjusting, auditing and consulting, or training - you gain access to this substantial knowledgebase.

The Cost-Benefits of Experience

Our experience impacts every decision we make. When you outsource to inHEALTH, you obtain motivated and professional niche experts, which translates to quantifiable cost-benefits for your organization. Our experts know from experience how to direct energy toward value-producing activities, while avoiding inefficiencies. All of our services, from medical management to complex dispute resolution, lessen your indemnity and lower your expenses.

Our record speaks for itself. Through our Specialized Settlement and ADR services, we save our partners millions in potential legal fees alone. Our innovative technology and experience allows us to handle large volumes of claims quickly and effectively, and our Intake Optimization Study (see below) proved that applying inHEALTH's experience and expertise to the intake process drastically reduced the overall cost of claims for insurers. As consultants and trainers, we share our innovative solutions, identify, and help implement short or long-term optimization strategies within your organization.

Shorter Claim Lifecycle, Reduced Spend, Less Liability

At inHEALTH, we take pride in the quality of our work. That is why we conduct research and drive analytics from our injury claim services to audit their effectiveness.

Using a sample of over 700 AB claims, our research showed the substantial impact we achieved by optimizing two claim lifecycle metrics identified in the intake process – quality and timing.

The quality of the claim intake was optimized according to the following criteria:

  • Modified call structure technique involving empathy, education, and tele-help support
  • Auto pre-filled OCF 1 application for AB
  • Explanation of benefits

Timing was considered optimized if the initial contact with the claimant was <5 days from notice of loss.

We identified four claim lifecycle metrics that measured claim performance, impacted by three main cost drivers 1) overall lifecycle of claim 2) treatment lifecycle, and 3) legal representation.

Successful claim performance was judged according to these four metrics:

  • 'Closed' or 'Inactive' after 8 months
  • Had fewer than 2 Assessment requests
  • Had fewer than 2 Treatment plans
  • Did not seek legal representation after initial contact

The results of this study compare our optimized procedure against a 'traditional' model.

Claim
Performance
Metrics

Traditional Model

Traditional Model with optimized Timing

Optimized Model with optimized Timing and Quality

% of claims 'Closed' or 'Inactive' after 8 months

41%

49%

61%

% of claims with fewer than 2 Assessment Requests

43%

50%

75%

% of claims with fewer than 2 Treatment Plans

40%

48%

64%

% of claims with legal representation after contact

34%

19%

15%

 

This study concluded that across all four Claim Performance Metrics, optimized timing and quality of the claim intake substantially impacted the cost-expense of the claim. Claims that were handled with our optimized model overwhelmingly reduced the three main cost drivers for an AB claim; aging claims, excessive treatment lifecycle, and claimants with legal representation.

These results further enriched the analytics driving our business practices. We used this research to help build the matrix behind our configurable intake scorecard. This scorecard allows an organization to better understand the complexities of their customers' needs, enabling a more streamlined claim assignment process to prioritize resources.

intake scroecard

To learn more about this solution, contact service@inhealth.ca.

Canadian Owned and Operated

inHEALTH is focused on meeting the needs of the local market. As a provider operating in Canada, inHEALTH can guarantee privacy controls over your claimant data and any additional reporting provided with our services.