For the first time, a system-based calculation of the degree of disability
CLARA plus accelerates and increases the consistency of the processes leading to the final decision on disability benefit
CLARA plus can determine the degree of disability in 80% of claims
For a long time now, application, risk assessment and policy issuance have been automated processes at many disability insurers. However, it is a different story in the claims departments. Most applications for benefits are still checked manually. This is time-consuming, ties up resources and leads to a lack of consistency and reproducibility in terms of the decisions. With CLARA plus, disability insurers can exploit this improvement potential and determine the degree of disability with support from the system. CLARA plus thus represents an ideal expansion to CLARA, the claims risk assessment tool in the MIRA Digital Suite, which structures disability claims with the help of rule-based interviews, halving processing times in the process.
Automated claim assessment with CLARA plus
CLARA plus calculates the degree of disability with the help of highly standardised queries that are adjusted to the individual case.
The questions relate to the occupational profile and the medical diagnoses.
CLARA plus already covers more than 400 different occupational profiles and examines these in a fragmented way according to the part-time activities in each case.
The system also knows all standard diagnoses – including the most frequent mental illnesses.
The algorithm links the individual occupational profile with the medical diagnoses and identifies any functional limitations.
In this way, CLARA plus can calculate the degree of disability in up to 80% of all eligible applications for benefits.
CLARA plus in a nutshell
CLARA plus – The benefits at a glance
CLARA plus saves resources through automating the claim assessment and focusing on the factors that are relevant for the decision. This accelerates procedures and reduces administrative costs.
A further acceleration in processing times, in conjunction with consistent and transparent decisions on claims, will boost customer satisfaction and enhance the reputation of the provider.
CLARA plus makes dedicated review recommendations based on the medical diagnosis and progression. The system also simplifies the review by comparing and contrasting the medical documents. This can increase reactivation rates and further reduce claims costs.
As an expert digital system within the MIRA Digital Suite, CLARA plus opens up a wide range of options in terms of data analytics. In future, these will provide more detailed risk categorisation and portfolio analysis and, as a knock-on benefit, optimised risk management with improved pricing.