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Claims Leakage

Claims Leakage (CL)

Definition

Dollars lost through claims management inefficiencies that ultimately result from failures in existing processes (manual and automated). In other words, it's the difference between what you did spend and what you should have spent on a claim. The cause can be procedural, such as from inefficient claim processing or improper/errant payments, or from human error, such as poor decision-making, customer service, or even fraud. CL is often discovered through an audit of closed claim files.

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