Deliver Trustworthy, Differentiated Customer Experiences with a Unified, Digital Solution
FINEOS LISA utilizes the component-based capabilities of FINEOS AdminSuite to enable Australasian life insurers to offer a claims service with differing value propositions in line with specific customer needs.
LISA segments customers from the outset based on the information available and uses that to define the service model to apply to that customer. This enables insurers to provide claims services according to customer needs while remaining compliant. Further, it ensures trust and transparency to all stakeholders and efficient allocation of resources.
FINEOS LISA optimizes the rich insurance domain-specific data model of the FINEOS AdminSuite to ensure that data can be easily extracted to meet the claims components of many regulatory reports including LRS 750 and data collection standards outlined in ASIC 633.
Key Features
• Cloud-based, self-service portals designed to work on multiple platforms integrated to support the entire claims lifecycle, including individuals, roles, organizational entities, benefits and other services
• Comprehensive, robust search engine for real-time information sharing and collaboration among case managers, carriers, service providers, and claimants
• Robust APIs set for easy data and process integration to 3rd parties, service providers and vendors
• Extreme flexibility in segmenting customer information and configuring claim structures, claims assignments, case management, service delivery models, follow-ups, and payments
(including multi-lingual and multi-currency)
• Comprehensive, feature-rich claims payment structures including detailed calculations with explanations, backdating, audit-trails, recurring, one-time, full payment histories
• Rule-based analytics and extensive reporting for audits, compliance, performance management, fraud control and payment accuracy
• User-configured triggers and heat maps for intuitive claims life-cycle management and faster identification of abnormalities
Enable Customized Service Delivery and Innovation Through Segmentation
• Simplify claims intake for claimants, employers, call-center staff and others through Web-based, self-service portals with intelligent scripting
• Segment customers with user-configured service models to enable faster claims settlement and optimize staff resources
• Improve customer experience by reducing hand-offs and rekeying through one integrated user-interface and a unified technology platform
• Improve data quality and streamline processes to reduce errors with online validity, coverage verification, automated segmentation at the outset
• Monitor claims performance and payment trends against industry benchmarks to improve pricing, lower costs and reduce potential fraud
Increase Member Value by Aligning Service to Customer Segments
• Access policy, premium, beneficiary, and prior claims history online to guide decisions and prevent fraud
• Escalate complex cases to management faster for resolution
• Optimize claims handling strategy by triaging claims based on members’ needs and claims circumstances
• Settle simple claims faster through segmented service delivery models and automated straight through processing
• Improve communications among insurers, service providers, 3rd parties and claimants
• Reduce complexity of multi-party and vendor payments with a suite of configurable payment options to increase accuracy and speed
Increase Trust and Transparency
• Create adjudication models with specific timeframes and actions for investigation, assessment and decision-making that meet compliance standards
• Support the principles outlined in the Financial Services Council Code of Practice
• Provide structured data to meet regulator reporting requirements
• Meet requirements of AWS
Well-Architected Framework
• Comprehensive access to claims files for service inquiries, audits and to ensure compliance
• Unify software solutions to ensure one source of truth for customer information
FINEOS AdminSuite is designed specifically for the Life, Accident and Health industry. A comprehensive suite, it includes absence, billing, claims, payments, policy, and provider.
FINEOS AdminSuite is built on the robust Platform Capabilities and is designed to connect to the partners and digital platforms that increasingly define the insurance landscape.
FINEOS Life Insurance Solutions Australasia (LISA) is a market solution that utilizes the component-based capabilities of FINEOS AdminSuite to enable Australian Life Insurers to offer a claims service with differing value propositions in line with specific customer needs.
