Claims Management

Claims Management is offered across all covered specialties. Some clients may not have the in-house expertise while others may want a more specialized expert to review specific claims. Managing claims requires a highly structured and efficient system that empowers participating experts to more easily and quickly review claims made and render a determination to the client. The Company invests significant resources in the systems and infrastructure required to automate much of the Claims Management process. That automation produces an enormous data set from the metadata that is appended to each case review. This metadata in turn enables Onicol to perform more detailed and accurate actuarial analyzes that are provided as a stand alone Data and Actuarial System. Onicol's System enhances existing business lines or serves as a cornerstone for underwriting medical malpractice insurance.

The Company's Management Team has years of experience auditing medical treatment cases and serving as medical experts. We strongly believe that having automated, standard data sets and highly skilled clinicians, such as specialty nurses and interns, makes the process more efficient for experts and improves review procedures - making determinations more timely and accurate for our Clients.

Customers are able to outsource all or part of the claims management process to Onicol. While some Customers have claims management operations, those operations may be limited to reviewing cases for particular specialties or a certain volume of claims. Using Onicol's services allows customers to better handle periodic high volume or enable customers to broaden coverage to additional specialties. Here are some highlights of the Claims Management Program:

  • Comprehensive Claims Management
    • From Claim Made to Judgment
  • Focused on initial case review
  • Option to blind experts from representation (Expert does not know if the case is referred to Onicol by either Plaintiff or Defense)
  • Verbal or written reports
  • Automated Services, Meta Data and Interactive reporting allows "The Best" experts to review the case
  • Nurse and Intern Specialists review the case and create interactive timeline the Expert can then review
  • Research Support Services provide citations referred to by the Expert
  • Transcription services provided by medical professionals allow more time for review by Expert
  • Interactive reporting provides dynamic point and click information for Experts and Clients
  • Superior automation, efficiency, experts, and reporting makes for accurate decision making and superior claims resolution