FINEOS to deliver automated claims management solution for catastrophic personal injuries
FINEOS Corporation, a global provider of innovative enterprise software solutions for insurance, bancassurance, and government, has been selected by the Lifetime Care & Support Authority (LTCSA) of New South Wales, Australia, to deliver disability claims management for catastrophic personal injuries arising from motor accidents. The LTCSA is the statutory corporation responsible for paying for the treatment, rehabilitation and care expenses of people with serious injuries caused by motor accidents, regardless of who is at fault. A catastrophic personal injury normally requires significant medical treatment with long-term and permanent effects on the injured victim’s life. The case management capabilities within FINEOS Claims will be used to manage all case-related work, including forms, documents, in-bound and out-bound inquiries, and financial transactions.
The solution will meet the Authority’s specific requirements by providing:
- Disability case management for severely injured people
- Scripting for initial intake notification
- Management of scheme eligibility criteria
- Management of service requests and care needs planning
- Complaints and disputes handling
- Reserving and payments capture.
FINEOS’ experience in automating complex, long-tail claims and its experience in the public insurance arena were key selection criteria. FINEOS Claims already supports the ‘No Fault’ claims management scheme for ACC in New Zealand, and will shortly replace the existing legacy claims system at the Transport Accident Commission (TAC) of Victoria, Australia. So far this year, FINEOS has also announced new clients at the Road Accident Fund (RAF) of South Africa and Manitoba Public Insurance (MPI) in Canada.
Another factor favouring FINEOS is its flexible technical platform, with a web services design to offer insurers a service-oriented architecture (SOA) approach. This supports both significant business change (e.g. legislative requirements and new case management approaches) as well as ongoing support for iterative business refinement (e.g. improving individual service levels, specific supplier/stakeholder terms). FINEOS also offers strong regional support in Australasia in addition to formal user groups focused on sharing best-practice in claims management.
Michael Kelly, CEO, FINEOS Corporation warmly welcomed the LTCSA as a new client. “It would be fair to say that FINEOS continues to be the leading provider of complex claims management solutions for top tier institutions and is now the preferred solution globally for absence management and income protection lines offered by insurers, bancassurers and government agencies”.