The standard is yours. The comparison is ours.
Define what good claims handling looks like as topics, questions and scoring criteria. Use the template that fits each review, then compare results across audit periods, organizations and review types.
Set the template. Then review.
Each template holds your topics, questions and scoring method. Start from ours or build your own.
- Carrier GL Standard v3
- WC TPA Oversight
- Reserve Adequacy
- Reserving
- Liability & causation
- Regulatory compliance
- + 10 more
- Initial reserve within 30 days of first notice?
- Rationale documented at each change?
- Reflects current exposure?
- Meets
- Needs improvement
- Does not meet
- Not applicable
Any review, built your way.
A whole program or a single issue, one line of business or all of them, a file audit or the organization itself. You set the review up; the platform runs it.
A reserve adequacy review of workers’ comp claims handled by a TPA, run AI-led.
You define the review and write its criteria. The platform runs it, whatever it covers.
Each review keeps its own criteria and scoring. Results roll up to topic and overall scores, so you can track them across audit periods and organizations, even when the frameworks differ.
The AI knows what to look for.
An AI review starts from your guidelines, or best practice. It reads every note against them, flags what falls short and backs each finding with the notes themselves.
Settlement authority obtained and documented before any offer.
From your guidelines, or best practice where you don’t have one
No authority on file, yet an offer figure is already in play.
Does not meet · 77% confidence
Get authority on file before the next offer.
“Plan of action updated. Offer references a $50,000 figure; no management approval in file.”
Claim note, quoted word for word
Same framework, next audit.
Every topic lines up against the last review, so you see what improved and what slipped.