Teams  ›  Australia  ›  CTP & motor injury
CTP · motor injury claims

Your claims officers decide entitlement.
They shouldn’t be assembling the requirement set.

The scheme sets prescribed periods for each decision.
Before judgement begins, someone must establish which requirements this claim engages — and check whether the file answers each one.

Outcomer prepares the claim for them.
Your claims officer opens a Case Orientation Report, not a raw file.

What your claims officer opens

A Case Orientation Report instead of a raw claim file.

Every requirement the claim engages — the state motor injury legislation, the scheme guidelines, the treatment and decision periods, and your own handling standards — identified for consideration, with the evidence on the file set against each one. It states the position on each requirement. It never reaches the entitlement decision.

One requirement, as it appears in the reportIllustrative
A decision on the treatment request was made and notified within the period the scheme guidelines allow.
Scheme guidelines · treatment decision period · version in force at date of accident
Evidenced — inferred
A decision letter is on file inside the period. The date the request was received is taken from the file notes rather than stated on the request, so the position rests on inference.
Requirements are prepared this way across eligibility, each benefit head, treatment approval, decision periods, and your own handling standards.

Two rails, clearly separated. The statutory and regulatory requirements for the jurisdictions you write in, and your own handling standards alongside them. Your examiner can see at a glance which findings carry regulatory exposure and which are your house rules.

It reports the file, not the examiner. It states what the record shows and what it does not — never what anyone did or decided.

It can be run at the beginning, and again whenever the claim is updated, to orientate the examiner. Requirements that did not exist at intake appear with their own deadlines, and evidence that was absent becomes present.


What it returns to the desk

Less manual preparation. More time for the decision.

Outcomer removes the manual work your claims officer does before judgement can begin — establishing which scheme requirements and benefit heads the claim engages, and checking the file against each one. That time returns to the decision you employ them to make. Judgement minutes are unchanged; every minute saved is preparation.

An estimated 42% less time on each claim —
around 73% more capacity from the same team.

Estimated from a task-level decomposition of a contested CTP claim at the point of an entitlement decision, taking the conservative end of each range and including the time to run and read the report. Judgement minutes are unchanged — the saving is all preparation. These are our figures, not measurements on your claims; we go through the working against your own case timings in the demo.


Configured to your work

Configured to your rule book, and signed off before anything runs.

Two sets of requirements govern a motor injury claim, and the report names both. Your standards sit in your own configuration only. Nothing derived from them enters the shared regulatory corpus, and no other client’s configuration can draw on them.

The scheme matrix

The state motor injury legislation and the scheme guidelines — each requirement, the version in force, and the period that attaches to it. Public, identical for every insurer in the scheme, built once. You review it and sign it off.

Your own standards

Your contact standards, authority limits, referral criteria and documentation standards, set alongside the guidelines rather than merged with them. You confirm the rendering represents your manual.

Maintenance is agreed at the same time — we monitor the instruments, decompose any change, you sign it off, and it applies from the effective date. Requirements are date-gated, so a claim from 2021 is examined against the rules as they stood in 2021.


What changes for the desk

Six things your claims manager sees.

  1. Fewer prescribed periods missed.Every decision period the claim engages is identified before the clock runs, not after.
  2. More claims closed per officer without adding desks.The capacity comes out of preparation, not out of the time spent deciding.
  3. A new joiner works to the same standard as your most experienced officer.The same requirements, in the same order, on every claim.
  4. Fewer benefit heads overlooked.An entitlement nobody identified was never in the file, and never in the estimate.
  5. Fewer files back on a team leader’s desk.The position on each requirement is complete and recorded the first time.
  6. When the regulator reviews the file, what was considered is already in it.A dated record on every claim, not the sample that happens to be pulled.

How it runs

In your estate, against the requirements in force at the time.

An orientation layer that sits alongside your claims administration system. Outcomer does not replace or write to it. It reads the file and states the position; your examiners decide and update the record. No migration, no change to how claims are administered.

Outcomer deploys as a container inside your own environment. The software and the model run in your estate, and nothing about the claim leaves your tenancy.

Built to fit your claims workflow. Outcomer can operate as a standalone workflow during evaluation, or integrate with your existing claims-management environment so the Case Orientation Report becomes another part of the claims officer’s existing workflow.

Schedule a 20-minute demo and see how it matches your desk’s work.

We will show you a Case Orientation Report, walk through how the matrix is configured and signed off, and go through the capacity estimate against your own case timings.