On a contested claim the file is the defence.
What was considered, when, and on what evidence is discoverable — and the attack works on the gaps.
When a decision is challenged, you can show every provision that applied
and what the file evidenced against each one.
Every provision the claim engages — Labor Code, Title 8, the medical-legal and permanent disability requirements, 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 examiner can see at a glance which findings carry statutory 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.
On a contested claim, the questions asked later are about what was considered and when. Outcomer establishes which provisions the claim engages and checks the file against each one, so the position on every requirement is recorded and dated before judgement rather than reconstructed after a challenge. Your examiner keeps the argument. Outcomer keeps the record.
An estimated 35% less time on each claim —
around 54% more capacity from the same team.
Estimated from a task-level decomposition of a contested indemnity claim at the point of a substantive determination, 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 California, 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 provision engaged by a contested indemnity claim — 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 escalation criteria, reserve authority, counsel referral triggers and roundtable standards, decomposed into requirements and set alongside the statute 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 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 examiner’s existing workflow.
We will show you a Case Orientation Report produced against a published California decision, walk through how the matrix is configured and signed off, and go through what the record shows when a determination is challenged.