CLAIMS OPERATIONS
TPA Services
Scalable claims support and investigative services.
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Operational capacity built around the claim lifecycle.
MODLAN combines field and desktop claim support, triage, review, inspection, lifecycle analysis, and investigative escalation through one controlled operating model. Scope and service parameters remain governed by the client agreement, assignment instructions, jurisdiction, and applicable licensing.
CAPABILITY FAMILIES
From intake through review and escalation.
CLAIMS OPERATIONS
Independent Adjusting
Objective adjusting and defensible outcomes.
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Desktop Adjusting
Efficient remote claim reviews and validations.
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Claims Triage
Structured intake review and routing support.
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FNOL Support
Structured first-notice operational support.
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Coverage & File Review
Structured claim-file review and chronology support.
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Property & Auto Inspections
Field documentation tied to the authorized assignment.
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Estimate Review & QA
Structured estimate and file quality review.
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Claims Lifecycle Analysis
Intelligence across the entire claims journey.
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Subrogation Support
Fact and evidence development for recovery review.
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Catastrophe Support
Scalable claim and field support for catastrophe assignments.
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Specialty & Complex Claims Support
Structured support for complex, high-documentation claim matters.
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Managed Claim Review
Structured file review, exception identification, and governed escalation.
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Claims Quality Assurance
Evidence-backed quality review for authorized claim programs.
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MODLAN does not need to replace the carrier core.
Assignments, evidence, notes, status and approved outputs can be exchanged through controlled integrations while source identifiers and provenance remain attached to the record.
ESCALATION
Claims and investigations stay distinct.
Where a matter requires SIU or investigative work, claims handling and investigative functions can remain separately staffed and separately documented.
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