According to industry studies, over forty percent of reported auto related soft tissue claims stem from non-existent, pre-existing or exaggerated injuries. Additionally, scores of studies by Injury Sciences throughout the auto insurance industry have shown that early intervention with science can reduce overpayments for fraudulent soft-tissue injury claims by as much as 70 percent. Insurers now have an automated way to consistently apply science in the identification and proactive resistance of costly soft-tissue injury fraud.

Objective science applied to every claim

Crash Severity Scoring™ and Claim Triage technologies automatically score all incoming repair estimates written for an auto insurer and flags those claims that are candidates for low impact/injury causation analysis, or that demonstrate potential for fraud. Crash Severity Scoring™ is performed by applying data from decades of crash research and the science of crash reconstruction to each and every repair estimate to objectively identify low to moderate severity collisions. Injury Sciences' Crash Severity Scoring™ System can accept repair estimates directly from any of the providers of auto material damage or estimate aggregation platforms in either BMS or EMS compliant formats. Claim Triage matches injury claim data with a collision's Crash Severity Score to flag those soft-tissue injuries that are potentially fraudulent or exaggerated. Flagged claims are then automatically routed to the appropriate specialist for further review, investigation and resolution.

Benefits include:

• Early warning and deterrence of fraud. Claims that have injuries that are potentially exaggerated or unrelated to the collision are flagged early in the life cycle of the claim. As a result, unwarranted payments for fraud or overpayments for exaggerated soft-tissue injury claims can be pre-empted with an appropriate investigation and proactive resolution.
• Reduced cycle time. Early and appropriate intervention of flagged claims equates to faster resolution and closure.
• Objective and consistent decision making. Work assignments and investigation steps are based on objective science, not the appearance of a claim or intuition. As a result, claims are more consistently resolved.
• Immediate results. The benefits start as soon as crash severity scoring and claim triage are deployed.

Improve workflow and resource utilization

Crash Severity Scoring™ and Claim Triage technology provides the ability to flag claims at several levels. Potentially fraudulent or exaggerated soft-tissue injuries can be flagged at the claim, claimant, and injury level. Once an opportunity has been flagged, it can be automatically routed, based on customized workflow rules, to the appropriate specialist for further handling. Additionally, flagged opportunities can be further qualified or disqualified based on objective and scientific investigation guidance.

As a result of these workflow features, claims that should pass through the claims process are not "over worked" or unnecessarily delayed and those that are flagged for exception processing are assigned to the claims professionals with the best skill set to appropriately investigate and resolve the claim. Consequently, the productivity and efficiency of the claim staff is optimized.