TPA & CLAIMS OPERATIONS

Claims support designed around the program, the file, and the evidence.

MODLAN can support discrete assignments or broader claims programs while keeping client guidelines, jurisdictional requirements, investigative separation, evidence custody, and system-of-record context explicit.

CLAIMS OPERATIONS

Intake & Triage

Structured first-notice support, assignment intake, and claim triage aligned to client instructions.

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CLAIMS OPERATIONS

File & Coverage Review

Disciplined review of file facts, documentation gaps, chronology, and authorized coverage-support questions.

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CLAIMS OPERATIONS

Field & Inspection Support

Property and vehicle documentation tied to the assignment, jurisdiction, and client requirements.

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CLAIMS OPERATIONS

Estimate & Quality Review

Estimate and documentation review designed to support consistent claim handling without inventing client rules.

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CLAIMS OPERATIONS

Investigations

SIU, statements, scene work, surveillance, canvass, locates, and other regulated investigative services where authorized.

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CLAIMS OPERATIONS

Evidence & Intelligence

Preservation, authentication, submitted-media review, and public-source intelligence with documented custody and limits.

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CLAIMS OPERATIONS

Lifecycle Analysis

Chronology, evidence, claim context, and operational signals organized for authorized decision support.

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CLAIMS OPERATIONS

TPA Program Operations

Program-level assignment, governance, evidence, and integration support under client-defined controls.

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CLAIMS OPERATIONS

Secure Interoperability

Controlled claims-platform, evidence, and CST interoperability for carrier and TPA ecosystems.

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ENTERPRISE OPERATING MODEL

Modular when you need capacity. Connected when you need orchestration.

Claims operations, investigations, evidence services, vehicle intelligence, secure exchange, and CST-enabled decision support can remain separately governed while sharing authorized context and provenance.

ENTERPRISE SERVICE FAMILY

TPA & Claims Operations

Program operations that can scale from a single assignment to coordinated claims support without turning client authority into a MODLAN assumption.

WHAT WE CAN SUPPORT
  • FNOL and intake support
  • Claim triage and assignment routing
  • Desktop and field claim development
  • File, estimate, and quality review
  • Specialty and complex-claim coordination
  • Lifecycle analysis and subrogation support
  • Program governance and operating support
01

Assignment Support

Use MODLAN for a defined claim task, review, inspection, investigation, or evidence need.

02

Program Capacity

Add governed operating capacity around an existing carrier or TPA program without replacing the client system of record.

03

Coordinated Operations

Connect claims, SIU, evidence, technical, and integration work through explicit handoffs and ownership.

CONTROL BOUNDARY

Breadth without role confusion.

MODLAN can connect multiple disciplines, but the engagement still preserves authority, licensure, evidence, and professional-role boundaries.

LAUNCH DEPENDENCIES

What has to be true before this service family scales.

These are public-safe planning dependencies, not universal contractual requirements. The actual program depends on jurisdiction, client policy, professional role, contract, data, and technical environment.

ACCOUNTABLE OWNERCarrier / TPA program owner

Program growth should preserve a named owner for material scope, authority, and launch decisions.

DEPENDENCIES
  • Program authority and claim-system ownership
  • Assignment routing and escalation rules
  • Service-role separation where required
  • Evidence and integration handling model

CONNECTED PLATFORM LAYER

Services can connect without becoming the same service.

CONNECTED CAPABILITY

Assignment Governance

Purpose, ownership, jurisdiction, status, and escalation can be preserved as distinct operating records.

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CONNECTED CAPABILITY

Secure Evidence

Matter-scoped evidence exchange can remain separate from ordinary claim notes and email attachments.

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CONNECTED CAPABILITY

Carrier Integration

Approved data can move through governed mappings, reconciliation, and source-of-record controls.

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