OneShield Market Solutions Claims

Automate and streamline every stage of the claim administration cycle — all with detailed reporting and analysis.

In today’s competitive marketplace, delivering seamless customer experiences and top-notch service is paramount while running your operations as efficiently as possible. Claims organizations are pressured to process claims in near real-time with minimal intervention and provide risk reduction strategies and loss prevention tools. Benefits from OneShield’s full-featured SaaS Claims module offer an end-to-end alternative for traditional manual-based claims processing. OneShield Market Solutions Claims module automates and streamlines every stage of the claim lifecycle reducing your overhead expenses, improving your operational efficiencies and service quality, and enhancing your business acquisition.

Adaptable, integrated, and secure, the OneShield Market Solutions Claims Administration module reduces rising IT costs and pressures, leaving you more time to focus on business priorities like customer service, growth, and innovation. From the First Notice of Loss (FNOL) to file closure, we can quickly and easily customize workflows, business rules, codes, tables, forms, and documents to match your desired processes. Now you can more easily manage your business to the standards set by you and your customers.

Claim Management Features:

• Full-featured First Notice of Loss (FNOL) & First Report of Injury (FROI);
• Claim summary and detail screens;
• User dashboard providing one-click access to all aspects of claims lifecycle (reserving, 3rd party management, payment/ recovery);
• Assignment administration;
• Custom claim adjudication;
• Reserve and sub-reserve categories;
• Litigation management;
• Return to work tracking;
• Subrogation management;
• Medical case management;
• Time tracking components;
• Special investigations module;
• Automated fraud scores and identification;
• Reporting and analytics.

Functionality at your fingertips

OneShield empowers claims professionals to support multiple clients, accounts, and lines of business with a secure, cloudhosted and configurable end-to-end claims administration solution.

Information when and where it’s needed:

• Customer Center provides a 360-degree view of existing and prospective accounts, brokers, vendors, insurers, carriers, and representatives.
• Integrated Journal & Task Management, including one-time and recurring diary entries with automated escalation, system and user-created notes, correspondence generation from templates, and embedded email integration.
• User Administration and standard integration to third-party applications, including financial and general ledger systems.
• User Dashboard provides a complete snapshot of appointments, daily activities, critical alerts, and open workflow steps. Users also have quick access to all open applications, submissions, and policy records and direct access to action items, contacts, reports, financials, search, and administration.