Clearspeed’s one-to-one, in-the-moment assessments unlock a new way for
workers’ compensation insurers to quickly understand who or what to trust.
During the initial intake stages of workers’ compensation claims, insurers are often forced to make decisions that rely heavily on self-reported details with limited objective evidence, minimal context, and inconsistent data accuracy. Without good data, insurers struggle to move trusted claims forward quickly. This results in wasted resource strain, millions of dollars in fraudulent claims payment, and an unnecessarily cumbersome process for people seeking support.
Identify high-trust claims, and stop the fraudulent ones early
Clearspeed’s voice-based risk assessment technology is purpose built to solve for the tension between speed and accuracy at key workers’ compensation claims intake decision points. Our individualized and real-time assessments of risk unlock a new way to understand potential fraud in real-time, providing a unique insight that enables better, faster decision-making, and remedies the tradeoff between pace and rigor.
Fast, individualized assessments of transactional trust
Clearspeed voice-based risk assessment analyzes the responses to a short set of customized and automated yes/no questions for universal vocal characteristics known to be associated with risk. This delivers a point-in-time, individualized assessment of potential fraud for each claim on a number of key areas where data is previously hard to verify or validate:
- How the injury occurred, including equipment or work conditions
- Improper attribution of non-work injuries to the workplace
- Shifts in the injury date/time
- Chronic issues masked as a sudden workplace event
- Previous claims of physical capabilities before the incident
- Omissions of prior medical history
- Validity of pain or limitations differs by audience
- Claim attempts based on ‘new’ symptoms after an initial denial
- Conflicting and multiple diagnoses
- False diagnoses
- Medical provider kickback schemes
- Mutual cover agreements among coworkers
- Inconsistent witness statements
Easy insertion into existing workflows
The Clearspeed voice-based risk assessment process starts with claimants being presented with the Clearspeed questionnaire on any voice-enabled device. Clearspeed analyzes the claimant’s vocal response to the case-specific question set, quickly identifying and scoring indicators associated with risk. Individualized results are then returned via API or available with the Clearspeed web app to inform next steps in claims pathing.
Clearspeed Benefits
Get faster, more accurate determinations
• Simplify claims screening
• Get unique risk insights where data is either challenging to find, or lacks accuracy
• Fast-track high-trust applications with confidence
• Undertake additional scrutiny on claims with focused insights on fraud potential
Boost equity and reliability
• Ensure consistent, fair outcomes across all individuals with objective and unbiased assessments
• Improve the customer experience for genuine claimants by eliminating unneeded investigation rigor
Optimize resources and investigation spend
• Reduce investigation cycles for applications where trust is high
• Eliminate unnecessary recorded interviews, surveillance details, detailed social media & open-source intelligence checks, or database sweeps for past injuries, overlapping claims, or serial claimant behavior
• Focus skilled underwriters exactly where potential fraud risk is flagged
Discover how Clearspeed can help you make faster, more confident decisions on approval of workers' compensation claims.
Learn more at www.clearspeed.com
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