Insurance Carriers

Polonious is the leading enterprise case management system used by many insurance carriers and is a comprehensive fraud platform that enables them to manage investigations, vendors and information/data partner requests from within a secure platform.

Polonious can be operational quickly with pre-defined, best practice investigative workflows for:

✓ Insurance Claims Fraud
• Major Case Investigations
• Panel Management
• Surveillance
• Internal Fraud

✓ Property & Casualty

✓ Healthcare

✓ Workers Compensation

✓ Liability

✓ Personal Injury

✓ Life & Disability
• Agent Market Conduct
• Anti-Money Laundering

✓ Audit Management

✓ Cyber-Security

✓ Whistleblower Hotline

✓ Human Resource Investigations
• Code of Conduct
• On-Boarding
• Off-Boarding

✓ Security

✓ Complaints

✓ Compliance Reporting

The cost benefits of moving to a single point of reference for users, vendors, clients and specialists with integrated messaging and document management enables an impressive return on investment.

Polonious – A Trusted Advisor to our Clients
Since 2006, Polonious has helped our clients refine their business processes to become more efficient, compliant and customer focused while reducing operational costs. Companies like CommInsure, IAGNZ, The Hartford, CNO Insurance, Protective Life, MetroPlus Healthcare and Kentucky Employers Mutual use Polonious to manage investigations for Auto Claims Fraud, Agent Market Conduct, Anti-Money Laundering, Privacy Breaches, Medicare Fraud, Workers Compensation Fraud, Assessing, Catastrophic claims assessing and investigation.

Whatever your challenges are, we have faced them before. Polonious brings to the table a wealth of problem solving experience and the market-leading platform for investigation case management.

PCMS Capabilities
Automated Workflows Your business processes are configured and automated in PCMS. This keeps investigations moving forward by automatically escalating cases and notifying the appropriate people when events happen or when investigations stall.

Dashboard
Once Logged in, users immediately see all relevant cases by status and timeliness. The users view of the cases is dependent on factors such as their role.

Action Logs
The hub of the system is the shared action log, where all actions on a file are recorded and shared.

Metrics
Collect user defined data for reporting, invoicing, payroll and case data. Metrics can include hours, mileage, expenses, quality control scorecards or any other measurable you wish to capture.

Offline
Allows investigators to work with the application and documents offline, then sync and upload their work product and reports once an internet connection is available.

Mobile Apps
Download Field Kit from Apple App or Google Play stores and access cases, add actions, record interviews, upload photos, make phone calls from contacts within the case, send emails and more on your iPhone, iPad and Android phones and tablets.

Business Intelligence Reporting Tool
Customized reports can be created via the Business Intelligence Reporting Tool. Reports can be designed on the desktop and deployed to the application for daily use on demand or be delivered via email to recipients at scheduled times and dates.

Drag and Drop Scheduling
With one action users can, allocate an investigator, edit event details (start, duration, notes, lock etc.), automatically email the investigator and add the event to the schedule of an investigator.

Connect
Polonious can interact with other leading solutions such as Notebook Analyst, Aptelisense, SynerScope, DecTech, Guidewire.

Mapping
Enhanced mapping capabilities can allocate the closest investigator from the map view, show recent cases, pin point claimants and identify future scheduled events in the vicinity.

Case Management – Solved
Do your Special Investigation Unit (SIU), Human Resources, and Risk Management departments use email, spreadsheets and databases to manage investigations?
Do you rely on outside investigation firms to conduct investigations and/or surveillance and have a need to evaluate your vendors?
Do your workflows fluctuate due to changing lines of business, state requirements or compliance issues?
Does your staff spend a significant amount of time creating and managing reports?

Do you want to:
• Reduce duplicate administrative work and turn around time?
• Improve vendor management?
• Take advantage of smart phone / tablet technology for investigators?
• Improve the security of case files?
• Separate investigation cases from claim files?

If your organization is not reaching its full potential because of operational inefficiencies or bottlenecks contact Polonious and see how we can help you.

Last updated: September 19th, 2014