Solutions, Property & Casualty, Auto Bodily Injury

Soft-tissue claims aren't soft

Auto BI is the highest-volume litigated line in P&C, where treatment patterns, attorney timing and provider networks decide outcomes more than the impact. Owl reads the police report, the dashcam, the demand and every record on intake, and matches it to PIP-mill patterns and venue verdicts.

Reconstructed loss at Bell Rd & 35th Ave, Phoenix AZ2025-08-14, 14:38
YOUstopped 14:37:48CLM28 mph at 14:38:11POINT OF IMPACTDASH-CAM14:37:48 → 14:38:14Insured stationary 3.2s priorTRAFFIC CCTVCity cam #4781, synced

28 mph

Impact speed

3.2s

Insured stopped before impact

$182K

Demand 81% over venue cohort

03A real claim, walked end to end

One loss: a stopped vehicle, a $182K demand, a venue with a verdict pattern.

Anonymized composite: rear-impact at city intersection, single claimant with represented PIP-mill treatment pattern, demand received 11 weeks post-DOL.

Claim #
BI-2025-08-14-0331
LOB
Auto BI, Personal
DOL
2025-08-14, 14:38
Demand
$182,400
Reserve (Owl)
$28,500
OwlVision
What it read
FNOL + recorded statement (claimant)
11 pp
Read, Indexed, Cited
Police report + traffic CCTV + dashcam
6 pp
Read, Time-synced
ER chart + radiology + PT notes (4 providers)
142 pp
Read, Coded, Apportioned
ISO ClaimSearch return
4 pp
Read, 3 prior matches
Demand letter + medical specials packet
67 pp
Read, Allegation graph
Structured extraction
DOL 2025-08-14 14:38, Bell Rd & 35th Ave. Insured stopped at red 14:37:48 (CCTV cam #4781 + dashcam confirmed). Claimant 28mph rear-impact 14:38:11 (3.2s stationary prior). No skid; airbags non-deploy. Claimant ambulatory at scene, ER same-day, 14 PT visits across 2 providers plus chiropractic and pain management. ICD M54.2 cervical strain. ISO ClaimSearch returns 3 prior BI claims same claimant (2019, 2021, 2024). Demand $182,400.
OwlSignal
What the world said about the claimant

External data only. None of this lives in your CMS. Owl gathered it from public records, professional networks, registries and the open web, then resolved it to this claimant.

ISO-01
ISO ClaimSearch: 3 prior BI claims

ISO ClaimSearch returns 3 prior BI claims on the same claimant: 2019 ($14K, NJ, soft-tissue), 2021 ($22K, AZ, cervical strain), 2024 ($31K, AZ, lumbar strain). All three involved soft-tissue cervical/lumbar treatment with the same provider network. None disclosed in current FNOL or recorded statement.

ISO ClaimSearchNICB ForeWARNCross-state claim history
PEX-04
Pre-existing condition: cervical degeneration

HL7 records exchange (with claimant authorization at PIP intake) returns prior MRI 2023-11 showing C5-C6 disc degeneration with chronic radiculopathy diagnosis. Treating physician for current claim documents same C5-C6 finding as “acute trauma-induced.” Apportionment opportunity: 60-70% pre-existing.

Datavant HL7 exchangePrior imaging registryPharmacy fill history (gabapentin, 18mo prior)
NET-02
Provider network: PIP-mill pattern

Treating chiropractor and pain-management provider share billing entity, common ownership and a referral pattern observed in 142 prior litigated BI claims in this venue. Average billing pattern: 14-18 PT visits + epidural injection at week 8. This file follows the pattern within 1 visit and 3 days.

NPPES provider registryCMS billing-graph analysisFlorida Bar / AZ Bar PIP-mill alerts
ADV-02
Plaintiff counsel: venue history

Counsel has 47 BI matters in Maricopa County in last 36 months. Median settlement-to-demand ratio: 0.18. 38 of 47 resolved sub-$30K despite avg demand of $148K. Three taken to verdict: two defense verdicts, one $42K plaintiff verdict on a 0-comparative left-turn fact pattern.

PACER + Arizona e-courtJury Verdict Reporter, MaricopaSettlement-pattern graph
WAG-01
Wage-loss claim: IRS variance

Claimed wage loss $14,200 over 9 weeks. IRS 4506-T (with claimant authorization) returns W-2 income $31,400 prior year and 1099 income $8,200 same year. Claimed weekly rate of $1,578 is inconsistent with documented earning history of $760/wk. Wage-specials reduce by ~52% on documented basis.

IRS 4506-TState UI wage records1099 cross-checkEmployer payroll filings
OwlAssist
What it answered
Examiner asked
What is our exposure given the ISO history and pre-existing condition?
Owl answered in 1.3s

Materially below demand. Liability is clean (insured stationary 3.2s pre-impact, dashcam + CCTV synced), so the comparative argument is closed. Damages exposure is the question. ISO ClaimSearch returns three prior BI claims with the same provider-network pattern; HL7 records show C5-C6 degeneration MRI 18 months pre-DOL with chronic radiculopathy diagnosis, contradicting the treating physician’s “acute trauma” attribution. Combined with the PIP-mill billing fingerprint and plaintiff counsel’s 0.18 settlement-to-demand ratio in this venue, recommended initial reserve $28,500 against $182,400 demand. Floor $14K (specials only), ceiling $52K (full PT + ER + apportioned MRI). Authority to settle by mediation.

ISO ClaimSearch, 3 prior matchesDatavant MRI 2023-11NPPES + CMS billing graphMaricopa verdict pattern, n=47
Examiner asked
Run the prior-treatment apportionment for the cervical claim.
Owl answered in 0.9s

Apportion 65% pre-existing. Pharmacy fill history shows gabapentin scripts active 18 months pre-DOL: chronic neuropathic pain treatment inconsistent with “asymptomatic prior to accident.” Prior MRI 2023-11 shows C5-C6 disc bulge 4mm with mild foraminal narrowing. Post-DOL MRI 2025-09 shows C5-C6 disc bulge 4.5mm, a 0.5mm progression within imaging-protocol margin of error. Treating physician’s “acute trauma-induced” finding is contradicted by the prior imaging. Apportionment: 65% pre-existing, 35% acute aggravation. Net specials reduce from $84K to ~$29K on apportioned basis under venue case law.

Pharmacy fill, gabapentin 2024-02MRI 2023-11 (prior)MRI 2025-09 (post-DOL)AZ apportionment case law
04OwlSignal external data

What the world says about your Auto BI claimants, none of which lives in your CMS.

Internal claim data is half the picture: it tells you what the claimant told you. OwlSignal continuously gathers external data (public records, professional and corporate registries, court dockets, social and open web) and matches it back to the claimant. These are the families that move the needle on Auto BI.

ISOISO ClaimSearch & NICB

Cross-carrier claim history via ISO ClaimSearch and NICB ForeWARN. Returns prior BI, PIP and UM claims on the same claimant across all participating carriers: the data your CMS will never have.

ISO ClaimSearchNICB ForeWARNCross-state claim registry
PEXPre-existing Conditions

External EHR pulls and HL7 exchanges that surface diagnoses, treatments, prior imaging and pharmacy fill history the demand letter does not disclose. Reframes apportionment from a debate to a documented fact pattern.

DatavantMRO, Verisma, CioxHL7 records exchangePharmacy fill history
NETProvider Networks

NPPES provider registry, CMS billing graphs, common-ownership analysis and PIP-mill pattern detection. Identifies the referral fingerprints that distinguish legitimate care from billing schemes.

NPPES provider registryCMS billing graphState Bar PIP-mill alertsOIG provider sanctions
ADVPlaintiff Counsel & Venue

Plaintiff-bar matter history, settlement-to-demand ratios, jurisdictional verdict-history graphs and demand-letter fingerprinting. The data on the other side that decides reserve and authority.

PACER + state e-courtJury Verdict ReporterSettlement-pattern graphDemand-letter fingerprint
WAGWage & Income Records

IRS 4506-T income reconstruction, state UI wage records, 1099 reconciliation, employer payroll filings. Closes the gap between claimed wage-loss and substantiated earning capacity.

IRS 4506-TState UI wage recordsEmployer payroll filings1099 cross-check
TELTelematics & Reconstruction

Vehicle telematics, EDR/CDR (event data recorder) pulls, traffic CCTV, dashcam time-sync. Reconstructs the loss to the second so liability and impact severity stop being opinions.

LexisNexis Telematics ExchangeEDR/CDR pullsMunicipal CCTV partnersDashcam OEM partners
Refreshed daily, matched by identity-resolution, every observation cited to its source.
05What changes

Numbers from P&C carriers running Owl on Auto BI in production.

MetricWithout OwlWith Owl
ISO + prior-treatment data on first reserve14%96%
PIP-mill pattern detection at intake11%84%
Demand-to-reserve accuracy band±58%±12%
Apportionment substantiated on close24%78%
Avg cycle to authority decision48 days11 days
Indemnity leakage per claim$5,800$1,400
Source: rolling 12-month average across 5 P&C carriers, Auto BI only, n = 184,000 claims.

Built for the regulatory shape of Auto BI.

UCSPA, NAICUnfair Claims Settlement Practices: every Owl-assisted decision cited and auditable.
State DOI examAudit trail per claim, per touch, per citation. Export to your DOI format.
Fair Claims Settlement PracticesCA §2695, NY Reg 64, FL §626.9541, built into the workflow, not bolted on.
HIPAA + FCRARecords exchanges run under signed authorizations; FCRA-permissible-purpose tagged on every pull.
ISO ClaimSearchNative carrier-of-record filings and queries. Match score and confidence persisted to the file.
Reg AI / NYDFSBias testing, model documentation, human-in-the-loop on every adverse decision.
SOC 2 Type IIAnnual audit. Continuous controls monitoring. Report available under NDA.
Records retentionConfigurable per state, per LOB, per carrier policy.
07Integrations

Lives where your Auto BI files live.

Claim systems

Guidewire ClaimCenter, Duck Creek, Origami, Snapsheet, in-house

Estimating

CCC ONE, Mitchell, Audatex, Xactimate (subro)

Records exchanges

Datavant, MRO, Verisma, Ciox, HL7 partners

Industry data

ISO ClaimSearch, NICB ForeWARN, LexisNexis, TransUnion TLOxp

Document intake

Box, OnBase, Documentum, ImageRight, Kofax

Identity & SSO

Okta, Azure AD, PingFederate, SAML, SCIM provisioning

08Get started

Bring us a closed Auto BI file. We’ll show you the ISO match, the prior MRI and the venue verdict pattern you missed.

Two-week pilot. Your records, your tenant, your ISO carrier-of-record. We measure cycle time, reserve accuracy, ISO + apportionment catch-rate and indemnity leakage against your own ground truth.