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 severity 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
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
- Claim management interface with customizable workflow to ensure high efficiency use
- Managerial and executive dashboards with drilldown reporting to easily monitor triage accuracy, litigation prevalence, fast-track efficiency, and overall system performance
- Software service with minimal IT requirements for the carrier. EvolutionIQ is responsible for carrier claim and external data ingestion, analysis, and reporting which allows for quick implementations