I have been in the claims business a long time and over the course of my career there have been a lot of changes. One area that has lagged behind the technology curve is subrogation.
Most certainly there have been some advances in modeling that do a decent job of finding about 80% of subrogation opportunities. That would include Chameleon, with one major exception.
Most models are built around algorithms. This is great MOST of the time. But due to the myriad of claims circumstances and nuances of things like the Jones Act, PIP laws, bailment principles, Workers’ Compensation rules and regs and other unique claims factors, it is impossible to build an all encompassing algorithm.
What struck me when I first started using SecondLook some fifteen years ago was the depth of knowledge in the organization. After managing many vendors for a large, global carrier, it became rather apparent that many did not have extensive claims knowledge or experience. To me, this was SecondLook’s key differentiator, and one of the big reasons I am here today.
When Chameleon was introduced by Ed Jordan, president of SecondLook, it provided its own differentiator by modeling the behaviors of over 600 years of claims expertise, which is how the team at SecondLook finds money that others routinely miss.
Case in point, New York PIP. We reviewed 100,000 closed NY PIP files for a Top 10 carrier that had been reviewed by both the carrier subro team and their “second look” vendor. With the Chameleon approach, our third look identified and recovered another $2 million dollars that was missed by both carrier and vendor.
The reason we don’t charge for these reviews is that Chameleon data tells us we will find missed recovery opportunities in 99.9% of the audits we conduct.
The power of Chameleon lies in both the underlying data set with extensive historical knowledge that can predict for the future PLUS the modeling of behaviors to help identify lower scoring files, typically removed by routine algorithms, that actually do have recovery potential.
Chris Tidball is an Executive Claims Consultant with SecondLook, Inc. His claims career spans more than twenty five years in adjusting, management and executive roles with major Top 10 carriers and leading claims enterprises. He is the author of several books, including Re-Adjusted: 20 Essential Rules To Take Your Claims Organization From Ordinary To Extraordinary! He is the creator of the television screenplay The Adjuster. To learn more about SecondLook, or to arrange for a free closed file review, please contact email@example.com or (904) 742-9031.