Workers Compensation

EvolutionIQ is the industry’s first comprehensive claim monitoring & alerting system.

EvolutionIQ is the industry’s first comprehensive claim monitoring and alerting system. The system’s guidance platform reviews all data, documents, and correspondence associated with a file each day, enabling carriers to remain proactively on top of every claim. EvolutionIQ automatically triages incoming claims, delivers actionable alerts on unrecognized serenity to adjusters and management, and recognizes the signs of impending attorney involvement or litigation.

Throughout the claim lifecycle, adjusters benefit from in-depth context on every claim, ranging from real-time reviews of the entire medical file, to litigation avoidance strategies, and other cost and expense-saving information.

Core Business Value

Automated adjuster assignment

Triage claims in real-time based on claim trajectory & adjuster historical performance

Icons_111620_icon-accuracy
Stop adverse developments

Live monitoring & alerting to halt unrecognized severity and escalations

Inventory X-Ray for Managers and Executives

Understand your entire book of open claims using EvolutionIQ to see every risk, on every claim

Standardize Expert-Level Claim Handling

AI-powered claim summarization makes predictions & risk factors easy to see for adjusters and allows them to act faster

Workers Compensation Carriers

Workers Comp adjusters confront complex, evolving injury and diagnosis patterns. With EvolutionIQ active claim monitoring and guidance, adjusters are able to focus on timely, actionable claims across their entire inventory. By providing clear claim summaries and context, adjusters can see impact opportunities more easily.

Product Overview

Adjusters and managers see the entire risk profile, injury trajectory and expected off-work duration for every open claim. They are alerted to high risk claims, significant attorney involvement likelihoods, and material changes to expected claim costs. With EvolutionIQ monitoring the entire claim file and complex medical information, the adjuster can focus on being a claimant advocate and managing the exposure to the carrier.

Results at Top Carriers:

Outperformed senior claims professionals on severity & eventual cost recognition in repeated blind trials across the claim lifecycle

Directly alerted claims teams on tens of millions of dollars in unrecognized severity

Insights so accurate they’ve been included in CEO dashboards for entire carrier groups

Application Features