Liability and Injury Evaluations: Understanding the Two Types of Recommendation Models
Third party bodily injury teams use a number of different approaches and tools to settle claims, 但他们确实有着相似的目标——高效、准确地解决索赔问题. 在第三方索赔过程中有这么多因素在起作用，包括 调节器的营业额, workload, 调整人员与管理层的目标一致, 缺乏报告等等, 许多运营商都在努力在整个组织中一致地实现这些目标. Establishing a consistent approach to liability and injury evaluation is foundational to effective bodily injury claim handling. Moreover, implementing this step is vital to consistent and accurate claim negotiations and settlements in practice. Many auto insurance carriers equip their adjusters with a set of tools and guidelines to help them during this stage of the claims process, but without a programmatic approach to assess and calibrate liability and injury across the organization, 理算员团队可能会在他们的索赔处理实践中产生分歧. A liability and evaluation recommendation model can help improve consistency and accuracy, 但是，了解哪种类型的模型适合您可能具有挑战性. 下面，我们列出了一些关键信息来帮助你开始.
什么是推荐模型?
Many carriers provide their adjusters with technology to help them through the liability and injury evaluation process. These technologies collect information about the claim and help create liability and general damages recommendations that adjusters can use to reach a settlement for the claim. For example, 取决于事故的具体情况, 这些类型的技术平台将收集以下信息:
- 事故情景(i).e.(十字路口与车尾)
- 损失时的天气状况
- 相关侵权因素(车速/车辆控制)
- 医疗评估数据(考虑的伤害或严重程度/原因)
根据收集到的数据, the tool will then use its pre-set model to calculate a potential liability evaluation range. It then walks the adjuster through a similar process to arrive at a recommendation for general damages and medical specials.
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有哪些类型的推荐模型可用?
Two types of recommendation models are the most prevalent in the market today: models based off of pure statistical analysis of historic carrier data and models built based on a combination of statistical analysis and on an insurance carrier’s best practices. While both types of models are built with the same purpose in mind—helping auto casualty insurance carriers improve consistency and accuracy in third party bodily injury claim evaluations—we believe the best practices recommendation model provides carriers with a slew of advantages over the historical data model. This type of recommendation or “knowledgebase” model helps carriers establish their own best practices, 将管理目标与调整者的目标联系起来 日常索赔处理流程 并帮助调整者在谈判过程中取得成功.
为什么最佳实践模式适合你
To help you understand in more detail why we believe the best practices model is the best option available in the market, 为了帮助你清楚地看到两种类型之间的区别, we’ve outlined the similarities and differences of a historical data model compared to a best practices model. 
有兴趣了解实际的最佳实践推荐模型? Find out more about Mitchell ClaimIQ >
主要功能和效益分析
As you can see, each type of model brings something different to each insurance carrier. 这样可以很容易地看到它们的区别, we’ve also put together a simple table that highlights the key features and benefits of each type of model.
最佳实践知识库模型:常见问题
While it may be easy to understand how a pure statistical model is built based on historical claims data, 您可能想知道最佳实践模型是如何工作和创建的. 下面，我们回答了关于这个模型最常见的问题.
如何收集最佳实践并将其纳入模型?
Typically, the best practices model is developed based on consensus modeling surveys of a carrier’s adjusters, 由于数据点的丰富，哪个提供了高度的数据置信度. 承运人选择他们的理算员进行调查，以帮助确定事故情况, 面试问题, 定义与每种事故类型相关的侵权责任, 确定严重性和因果关系等问题.
测量我的调整器如何帮助创造更好的结果?
Adjusters are the most important asset a claims handling team has—they carry the knowledge and expertise that help each company succeed. By leveraging the skillsets of the highest performing adjusters to help empower the rest of the claims team, 亚博真人官方版APP将自己设置为一致和准确的索赔评估, 不管理算员在处理索赔.
如果我的组织没有构建模型的专业知识怎么办?
Typically, an organization needs seven or more adjusters and other experts to build a best practices knowledgebase model. 模型可以从头开始构建, 或者，携带者可以从调查和受伤问题的起始菜单中选择, 责任义务以及更多帮助他们构建最佳实践模型的内容. The software provides detailed reporting and analytics to allow carriers to see their claim trends in real-time.
选择正确的推荐模型
The liability and injury evaluation step of the third party claims process is essential to get the liability and injury evaluation step right each time to can lay the foundation for timely and accurate claim settlements. A best practices model helps carriers align their claims handling philosophy with the day-to-day activities happening across the company and provides adjusters with the tools they need to succeed. 而历史索赔数据模型可能会更快地建立起来, we believe using a best practices recommendation model is the right choice for long-term success.