No-fault runs on prescribed timeframes.
Before judgement begins, someone must establish which requirements this claim engages in this state — and check whether the file answers each one.
Outcomer prepares the claim for them.
Your adjuster opens a Case Orientation Report, not a raw file.
Every requirement the claim engages — the state no-fault regulation, the verification and denial timeframes, the fee schedule provisions, 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 determination.
Two rails, clearly separated. The statutory requirements for the jurisdictions you write in, and your own handling standards alongside them. Your adjuster can see at a glance which findings carry statutory exposure and which are your house rules.
It reports the file, not the adjuster. 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 adjuster. Requirements that did not exist at intake appear with their own deadlines, and evidence that was absent becomes present.
No-fault statutes set prescribed periods — for acknowledging the claim, for requesting verification, and for deciding once the information is in. Every one of those periods has to be identified before the clock can be managed. Outcomer removes the manual work your adjuster does before judgement can begin — establishing which requirements the claim engages in this state, 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 41% less time on each claim —
around 70% more capacity from the same team.
Estimated from a task-level decomposition of a contested or verification-heavy no-fault claim, 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.
The statutory requirements for the states you write in, and your own handling standards, loaded alongside them under NDA. 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.
Every requirement engaged by a no-fault claim in the states you write — the instrument that issued it, the version in force, and the point at which it applies. You review the whole set and sign it off.
Your contact standards, authority limits, referral criteria and documentation standards, decomposed into requirements and set alongside the regulation rather than merged with it. You confirm the rendering represents your manual.
Maintenance is agreed at the same time — how the matrix stays current, how you tell us when your own standards change, and how each update is recorded. 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 adjusters 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 adjuster’s existing workflow.
We will show you a Case Orientation Report produced against a published decision, walk through how the matrix is configured and signed off, and go through the capacity estimate against your own case timings.