Automated quantum assessment

Author/contact: Karim Derrick.

When Kennedys IQ originally set off on the Portal Manager journey, we recognised that for most insurers, managing personal injury claims was onerous and that claim managers were struggling to get a handle on the bigger personal injury picture. Common complaints included:

a. Handlers having to use multiple systems to service their claims
b. Inconsistency around quantum assessment
c. Poor handler user experience
d. No ability to service claims falling out of the portal process without instructing lawyers
e. Inability to stop claims falling out of the portal process in the first place with no aggregated view of their claims

I was particularly struck by the amount of time being invested in quantum assessments and also the apparent lack of consistency. Insurers were quite clear: there was significant room for improvement.

Insurers have been adopting a number of strategies to value personal injury claims. Primarily using third party tools that require handlers to type in the injuries and prognosis detail or adopting insurer valuation matrices that, whilst manual, at least provide guidelines to help ensure handlers adopt the company’s own policy and tactics in managing those claims. None of these approaches is entirely satisfactory. And as we approach a new era of tariff based claims, the need to find new solutions to these old problems has never been more important.

From particle physics to quantum assessment

At Kennedys IQ, and over the last 2 years I have been working closely with Dr Harvey Maddocks to develop a new approach to quantum assessment that both automates and guarantees consistency. Harvey’s background is in particle physics having been a part of the team at CERN that discovered the Higgs Boson particle many years ago. Harvey has taken his ability to process vast amounts of digital information and applied it to analyse medical reports and optimise claim outcomes.

The approach that the Kennedys IQ Quantum tool takes is a complex but valuable process that supports handlers in their assessment of claim value.

How does it work?

a. Firstly stage 2 pack medical reports are machine read the moment they are uploaded into the portal. This happens before the handler even sees the medical reports.

b. Harvey’s sophisticated approach extracts key information from the medical report. Critically, that includes the injuries and prognosis. It also includes other contributing data such as the occupation of the claimant, the number of physio sessions they have received, time off work and much more. All of this data is buried within the medical report initially. Harvey’s software pulls this data out of the medical report and into the IQ Platform.

c. The application then cross references this data against the Judicial College guidelines for Claims Portal claims and against the new tariff damages for OIC claims in order to produce a valuation.

d. Finally this cross referenced data is then used to predict the optimum opening offer based on the IQ dataset taking into account many more factors that can include the claimant solicitors that are presenting the claim and historical settlement amounts.

First and foremost Quantum drives consistency and improves valuations. A lack of consistency ultimately costs insurers. Nobel prize winner Daniel Kahneman writes about overcoming the “High, Hidden Cost of Inconsistent Decision Making” recommending that professional services businesses adopt judgement tools that improve consistency and help to combat the negative consequences that include damages inflation.

However, there is another big win for the Quantum tool. It saves handlers a significant amount of time. Reading a medical report can easily take an hour of a handler’s time and since the process is onerous repetitive mistakes happen. Using a tool like Quantum removes that risk.

Ultimately, sensible use of your claims data using contemporary text analytics and machine learning techniques can help reduce the amount of time you take to process your claims – but more important than anything else, it puts managers in control of their claims process, giving you the tools to deliver a claims strategy that is informed by the best data available. Tools like Quantum not only extract data at the level of individual claims they allow you to zoom out and see your data at an aggregated level.

Product Manager Chris Stubbs explores the importance of this further in his blog here.