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EIS Group (San Francisco) has announced that the latest version of its ClaimCore claims management solution supports claims for disability insurance and enables benefits insurers to improve disability claims accuracy and efficiency, automate payment calculation, improve compliance and enhance customer service to employers, employees and brokers.
“Disability claims are quite complex and have often required too many manual processes at insurers,” comments Tom Scales, Head of Americas, Life, Annuity and Health, at Boston-based research firm Celent. “The level of automation now offered in ClaimCore, particularly the heavy calculations involved in disability plans and the ability to streamline processes, will be of big benefit to the insurer and the plan sponsors. The fact that this new release is already in production is a bonus.”
With the addition of disability claims, EIS positions ClaimCore as a complete system supporting all the core and voluntary products in group and individual, worksite and voluntary markets all on the same platform. The solution can be deployed as a standalone core system or as a modular component of EIS Core Insurance Suite, providing benefits insurers with additional options for transforming their legacy core systems, the vendor reports.
Currently in Production
EIS Group reports that ClaimCore for disability claims is already in production at one large, US-based benefits insurer and is currently being evaluated by additional carriers.
The vendor asserts that using ClaimCore for short-term, long-term and statutory disability claims provides insurers significant advantages, including the following, as described in an EIS statement:
- A single comprehensive claim solution: ClaimCore simplifies operations by introducing a single solution that replaces disparate technologies, including claims payment, workflow and document imaging solutions, to deliver accuracy and consistency to the disability claims process.
- A powerful payment calculation engine: ClaimCore addresses the complexity of disability claims payments with automated, out-of-the-box calculations for: pro-rating overlapping periods of time; multiple partial disability payment methods; offsets, deductions, taxes and liens; recalculating paid periods; and multiple methods of recovering overpayments.
- Seamless Integration with policy and customer data: ClaimCore connects to legacy policy and billing systems through a rich set of integration services to access all relevant disability claim eligibility information.
- Automated and auditable claims processes: ClaimCore leverages advanced workflow, rules and calculation engines to automate disability claims and help carriers improve customer satisfaction.
The vendor adds that when ClaimCore is deployed as part of its EIS Suite—composed of PolicyCore, BillingCore, ClaimCore and CustomerCore—eligibility, coverages and customer information are immediately available to claims operations without the integration burdens resulting from multiple vendor solutions. In addition, the common database and data model in the EIS Suite platform provides a single source of truth with data entered one time and leveraged throughout the entire customer lifecycle.
“We are very pleased to offer this superior disability claim management solution option to address the inefficiencies that can negatively impact claims customer service and increase expense for insurers,” comments Jim Eva, product executive for claims, EIS Group. “We have heard what our customers need and applied the computational power and design flexibility of the EIS platform to create a solution that works seamlessly within the EIS Suite or as a standalone component to deliver better claims outcomes.”