Entitlement turns on the policy definition, and the Code sets the periods.
Before judgement begins, someone must establish which requirements the claim engages — and check whether the file answers each one.
Outcomer prepares the claim for them.
Your assessor opens a Case Orientation Report, not a raw file.
Every requirement the claim engages — the Life Insurance Code of Practice periods and conduct requirements, the policy definitions, waiting and benefit periods and offsets, and your own assessment 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.
Two rails, clearly separated. The statutory and regulatory requirements for the jurisdictions you write in, and your own handling standards alongside them. Your assessor can see at a glance which findings carry regulatory exposure and which are your house rules.
It reports the file, not the assessor. 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 assessor. Requirements that did not exist at intake appear with their own deadlines, and evidence that was absent becomes present.
Outcomer removes the manual work your assessor does before judgement can begin — establishing which Code periods and policy conditions the claim engages, and checking the file against each one. That time returns to the assessment you employ them to make. Judgement minutes are unchanged; every minute saved is preparation.
An estimated 44% less time on each claim —
around 77% more capacity from the same team.
Estimated from a task-level decomposition of an income protection 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.
Three sets of requirements govern a life or income protection claim, and the report names all three. 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 Life Insurance Code of Practice and the conduct requirements that sit with it — decision periods, update intervals and required content. Public, built once. You review it and sign it off.
Disability definitions, waiting and benefit periods, offsets and exclusions from the wordings you write, with the version in force at the date of claim. This is where entitlement is decided, and it is yours.
Contact standards, authority limits, medical referral criteria and review intervals. 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.
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 assessors 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 assessor’s existing workflow.
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.