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LTI Disability Claims Management Solution

Unify the disability claims process with industry-leading intelligent processing

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While processing disability claims requires diligence and compassion, claim examiners often must search multiple legacy systems for relevant information while working under intense regulatory scrutiny. The result is a tedious process involving many workarounds ripe for errors and data inconsistencies.

Our solution Disability Claims Management focuses on the human-centric aspect of processes by providing an omni-channel customer service for intake, eligibility determination, and physician interactions. Powered by Pega's dynamic case management and suite of out-of-the-box calculators and integration, our solution can drastically reduce claims processing times, save costs, and transform the entire customer experience.

Scalable architecture

  • Flexible design to support multi-country roll-out
  • Extend framework to other lines of business
  • Using the latest features of Pega Platform 8
  • Utilizing the customer services strategic application to support easy extension to other services

Key Features

  • Pre-built disability intake, physician verification, employment validation, and return-to-work business processes
  • Omni-channel customer service: text, chat, email
  • Hierarchical case management for managing the entire claims process
  • System-driven correspondence and document generation using DocuSign
  • Multiple payout options including PayPal for faster payouts
  • Customer 360: Integration with key data sources so examiners can make informed decisions with all information available in one system
  • Automated red flags based on disability duration guidelines
  • Workflow-based calendaring and scheduling of appointments and follow-ups
  • Early intervention and follow up leads to early return to work, hence lower payout
  • Compliant with ODG guidelines (ICD and RTW)



Partner Name

Larsen and Toubro Infotech


  • Pega Products: Pega Claims for Insurance
  • Industry: Insurance
  • Pega Version compatibility: 8.1, 8.2, 8.3, 8.4

Offering Type

Packaged Service Offering

Published On

February 23, 2023

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