Product showcase: ACM's digital subrogation screening tool

Product showcase: ACM's digital subrogation screening tool | Insurance Business America

Product showcase: ACM's digital subrogation screening tool

American Claims Management says its new digital subrogation screening tool is already generating results after launching at the end of 2021.

Subrogation is the idea that an insurer can recoup costs, including your deductible, from an at-fault person or their insurance company. Early data for the SubroNet tool is promising, according to Dhara Patel (pictured), president of the San Diego-based third-party claims administrator.

“The number of what we call subrogation opportunities that have been identified have doubled,” Patel said of the tool’s performance since its December 2021 debut.

Specifically, the number of claims ACM is opening up for subrogation are about 48% higher over its first two months than is typical in terms of new referrals, she said.

“We’re excited about it,” she said.

The company plans to release more detailed success rate data after the first year or so.

“That’s how long it takes to really start getting in the dollars that that we’re looking for,” she said.

Longer term, ACM is betting SubroNet will help beef up the subrogation process and generate more opportunities for money recovery.

As Patel explained, the tool is designed to spot hidden subrogation possibilities, initially with property claims but in other areas such as workers’ compensation down the line. Once they’re identified, ACM’s dedicated subrogation team gets the referrals so they can pursue subrogation on property claims they’ve handled.

“We believe that there are subrogation opportunities that are hard to identify in claims,” Patel said. “There are subrogation opportunities. Some are very obvious, some are not, and we want to specifically target opportunities where we could recover money for our clients, the insurance carriers. “We want to maximize how much money we’re recovering from them.”

Machine learning

SubroNet is a machine learning tool that incorporates Natural Language Processing with a machine-learning algorithm. Language processing helps spot keywords in claims that are typical in successful subrogation cases, and then compares them with a loss description from an adjuster or customer service representative Next, the tool grades each subrogation opportunity as either low, medium or high.

To build the tool, ACM’s data science team worked closely with its subrogation manager and adjusters. Over a six-month period, they worked closely to spot all of the different places where the tool could look for terminology that indicates possibilities of successful subrogation. They also pulled 20 years of data shared with a machine learning team to look at past claims to see what subrogations were successful in the past and why.

“Once they started building the tool, there was a lot of testing and collaboration going on between the teams to identify … subrogation possibilities,” Patel said.

Typically, a claims adjuster handling a property claim spots a subrogation and makes a manual referral to the subrogation department to pursue it. The process is much simpler with SubroNet.

“If [adjusters] didn’t manually refer it as a subrogation claim, the tool picks up that there could be a subrogation possibility, and refers it,” she said.

ACM isn’t alone in the marketplace with its subrogation tool. When ACM debuted SubroNet in December 2021, it joined the market a few months before CCC Intelligent Solutions, a provider of data and technology for the auto and insurance industries, snatched up Safekeep, an insurtech artificial intelligence (AI) start-up focused on subrogation claims management technology.

Plenty of room

Both CCC/Safekeep and ACM’s subrogation tools seem similar on the surface, relying on machine learning models and Natural Language Processing to help spot subrogation opportunities. CCC will offer the service widely on its cloud-based platform, which reaches more than 30,000 companies including the top 20 auto insurers. SubroNet is focused on property initially and will expand over time.

The marketplace has room for many kinds of subrogation tools, Patel said.

“I am positive that there could be other indicators that could also point to higher rates of subrogation,” Patel said of the competitive possibilities.

ACM’s customer targets for its tool include domestic and international carriers with which it has contracts across the country.

“We handle [property claims] claims in all 50 states on their behalf, and this essentially benefits their money, right? We pay out claims on their behalf, so anything that we can recover that we pay out ends up benefiting them,” Patel noted.

ACM, which launched in 1988, specializes in both commercial and personal lines. It is a subsidiary of Arrowhead General Insurance Agency, Inc.