5 Ways Robots Reshape (and Improve) Workers’ Comp

Robots in workers' comp will enhance providers' ability to deliver high-quality care to injured workers and can help payers control pharmacy-related costs.
By: | November 7, 2018 • 6 min read

Robotic pharmacies are virtually eliminating costs related to medication dispensing errors. Image: Susan Merrell/UCSF

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Robots have been in the workplace since 1956, but it’s stunning how the machines have evolved since then. Robots and cobots in the workplace are boosting productivity as well as safety in a broad range of workplace environments. They’re also poised to have an impact on the workers’ comp field in a variety of ways. In the not-so-distant future, robots may impact your safety and workers’ comp programs in ways we couldn’t have imagined even 10 years ago.

1) Helping injured workers heal

A prototype robot for sports therapy has been developed in Singapore, aimed at providing a high quality, repeatable treatment routine to improve sports recovery.

The robot, named Emma — Expert Manipulative Massage Automation — treated 50 patients in early trials, including professional athletes with conditions including tennis elbow, stiff neck and shoulders and lower back pain.

Emma applying therapeutic massage to a patient autonomously. Image: NTU Singapore

Emma uses sensors and diagnostic functions to measure the response of a patient and the stiffness of a particular muscle or tendon. The detailed diagnostics are analyzed and uploaded to the cloud so that treatment and recovery can be measured and monitored by physicians and therapists. Treatment programs can be adjusted based on recovery progress.

Emma is undergoing user trials at Kin Teck Tong, a medical institution with a chain of clinics that offer sports injury rehabilitation and pain management through the integration of advanced sports science and traditional Chinese medicine.

Emma’s success has the potential to open a broad range of opportunities across the injury rehab and pain management industries.

Meanwhile in Poland, a robot named Luna is helping to enhance physical therapy for injured patients as they work to regain muscle strength. Luna uses electromyography, or EMG, to identify electrical currents as patients bend their arms or legs.

By detecting muscle tension not immediately visible to the human eye, Luna can help therapists choose the best exercises for patients, as well as provide them with real-time information about patient progress.

2) Enabling advanced solutions for traumatic injuries

Robotic exoskeletons are achieving great things for paraplegic patients with permanent injuries. But they are also becoming a vital piece of the recovery strategy for spinal injury patients that have the potential to walk again.

Technology like the Swiss-developed RYSEN harness can adapt as the injured worker recovers. The harness is attached to the ceiling, and uses a deep neural network algorithm that can “learn” where a particular patient needs the most support. This enables injured workers to regain their gait and balance at the right pace as their bodies heal.

Traditional rehab harnesses pull upward, making the patient shift their body weight backward — an unnatural condition for walking. RYSEN uses a computational model that can simulate normal walking by predicting the right configuration of forces to be applied to the patient’s trunk.

The harness learns how a person moves and where they tend to shift their weight and adjusts accordingly. It can also be used to move in multiple dimensions rather than simply forward, which lets patients practice a variety of movements such as moving between obstacles.

3) Packaging prescriptions for injured workers

Dispensing medication is a task well suited to machines. A robotic system receives a script from the physicians or the pharmacist, the robot picks the correct dose and quantity, packages it up and hands it over to an individual.

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Some human pharmacists may be wary of the technology, but employers and payers have cause to embrace it. A 2012 study done at a Houston hospital found that for every 100,000 prescriptions, pharmacists made an average of five errors. The Office of National Drug Control Policy reported to the Washington Post that as many as 5 percent of the 5 billion prescriptions filled each year are incorrect.

The Institute of Medicine’s Committee on Identifying and Preventing Medication Errors estimate that there are at least 1.5 million preventable adverse drug effects in the United States each year.

Robotic pharmacy systems are consistently bringing those figures close to zero around the globe.

UC San Francisco’s medical center and other hospitals have sustained long-term error-free dispensing with pharmacy automation systems. Image: Cornerstone Automation Systems

Nearly 70 percent of community pharmacies in Denmark use automated or robotic dispensing technology. The UK’s Wirral University Teaching Hospital NHS Foundation Trust reported a 50 percent reduction of dispensing errors in the four months after implementing a pharmacy robot.

In the U.S., the medical center at the University of California San Francisco is operating a proof-of-concept pharmacy at two hospitals, and the project has been working — 100 percent error free — for more than five years.

Pharmacy automation systems are increasingly being installed by various end-users such as hospital pharmacies, clinic pharmacies, retail pharmacies, mail-order pharmacies and pharmaceutical SMEs.

According to a recent Future Market Insights report, the global pharmacy automation systems market was valued at $3.3 billion in 2016 and is expected to register a compound annual growth rate of 6.2 percent from 2017 to 2027.

4) Adjusting injured workers’ claims

Well, no — robots can’t really replace adjusters. What they can do is take over the most clerical and transactional aspects of claims adjusting and allow human adjusters to focus on how they can add value to the claims experience from a claimant engagement standpoint.

Robotic process automation, or RPA, can enhance speed, accuracy, transparency and level of service … everything that matters most to injured workers.

The Office of National Drug Control Policy reported to the Washington Post that as many as 5 percent of the 5 billion prescriptions filled each year are incorrect.

Automation can ensure the right information ends up in the right systems and attached to the right claims, allowing human adjusters to act more efficiently. Automation is particularly effective for pulling data from standard fields on medical bills and for transferring and converting data across older claims systems into newer enterprise systems.

RPA can optimize claimant communication so that the right type of contact is made with the injured worker at the right time and through the right communication medium.

Robots can also quickly run quality assurance checks on entire populations of forms and payments to ensure accuracy. Anomalies and payment errors can potentially be flagged before the check ever goes out rather than being discovered by auditors after the fact.

As more carriers adopt mobile applications to streamline the claimant experience, these functions can be integrated with robotic process automation. Integrated chatbots can handle many routine communications tasks, including notifications of settlements and customer inquiries into claim status and payment status.

5) Freeing up lawyers to better leverage their expertise

In complex cases, it can take a large team of lawyers and paralegals to pore over every document related to the discovery process. However, that’s a task that can be accomplished via artificial intelligence at a fraction of the speed and cost it would take otherwise.

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Machine learning is the foundation of the predictive coding technology that has transformed eDiscovery, reducing the amount of data that need to be reviewed by upwards of 80 percent in some matters.

eDiscovery platforms are now using AI to substantially improve the discovery process. Discovery-related AIs find important documents, facts and issues with minimal effort at lightning speed. Lawyers and legal teams are able to identify key documents quickly and benefit from an automated recommendation engine without the need to be experts in advanced analytics.

In this case, it’s not about replacing humans with robots. It’s about to taking a job that’s potentially tedious, headache-inducing and at risk for oversight errors and shifting it to machines that are better suited to scanning and sifting through terabytes of data. This frees up lawyers and paralegals to spend their billable hours on high-value tasks. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]

Exclusive | Hank Greenberg on China Trade, Starr’s Rapid Growth and 100th, Spitzer, Schneiderman and More

In a robust and frank conversation, the insurance legend provides unique insights into global trade, his past battles and what the future holds for the industry and his company.
By: | October 12, 2018 • 12 min read

In 1960, Maurice “Hank” Greenberg was hired as a vice president of C.V. Starr & Co. At age 35, he had already accomplished a great deal.

He served his country as part of the Allied Forces that stormed the beaches at Normandy and liberated the Nazi death camps. He fought again during the Korean War, earning a Bronze Star. He held a law degree from New York Law School.

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Now he was ready to make his mark on the business world.

Even C.V. Starr himself — who hired Mr. Greenberg and later hand-picked him as the successor to the company he founded in Shanghai in 1919 — could not have imagined what a mark it would be.

Mr. Greenberg began to build AIG as a Starr subsidiary, then in 1969, he took it public. The company would, at its peak, achieve a market cap of some $180 billion and cement its place as the largest insurance and financial services company in history.

This month, Mr. Greenberg travels to China to celebrate the 100th anniversary of C.V. Starr & Co. That visit occurs at a prickly time in U.S.-Sino relations, as the Trump administration levies tariffs on hundreds of billions of dollars in Chinese goods and China retaliates.

In September, Risk & Insurance® sat down with Mr. Greenberg in his Park Avenue office to hear his thoughts on the centennial of C.V. Starr, the dynamics of U.S. trade relationships with China and the future of the U.S. insurance industry as it faces the challenges of technology development and talent recruitment and retention, among many others. What follows is an edited transcript of that discussion.


R&I: One hundred years is quite an impressive milestone for any company. Celebrating the anniversary in China signifies the importance and longevity of that relationship. Can you tell us more about C.V. Starr’s history with China?

Hank Greenberg: We have a long history in China. I first went there in 1975. There was little there, but I had business throughout Asia, and I stopped there all the time. I’d stop there a couple of times a year and build relationships.

When I first started visiting China, there was only one state-owned insurance company there, PICC (the People’s Insurance Company of China); it was tiny at the time. We helped them to grow.

I also received the first foreign life insurance license in China, for AIA (The American International Assurance Co.). To date, there has been no other foreign life insurance company in China. It took me 20 years of hard work to get that license.

We also introduced an agency system in China. They had none. Their life company employees would get a salary whether they sold something or not. With the agency system of course you get paid a commission if you sell something. Once that agency system was installed, it went on to create more than a million jobs.

R&I: So Starr’s success has meant success for the Chinese insurance industry as well.

Hank Greenberg: That’s partly why we’re going to be celebrating that anniversary there next month. That celebration will occur alongside that of IBLAC (International Business Leaders’ Advisory Council), an international business advisory group that was put together when Zhu Rongji was the mayor of Shanghai [Zhu is since retired from public life]. He asked me to start that to attract foreign companies to invest in Shanghai.

“It turns out that it is harder [for China] to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.

Shanghai and China in general were just coming out of the doldrums then; there was a lack of foreign investment. Zhu asked me to chair IBLAC and to help get it started, which I did. I served as chairman of that group for a couple of terms. I am still a part of that board, and it will be celebrating its 30th anniversary along with our 100th anniversary.

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We have a good relationship with China, and we’re candid as you can tell from the op-ed I published in the Wall Street Journal. I’m told that my op-ed was received quite well in China, by both Chinese companies and foreign companies doing business there.

On August 29, Mr. Greenberg published an opinion piece in the WSJ reminding Chinese leaders of the productive history of U.S.-Sino relations and suggesting that Chinese leaders take pragmatic steps to ease trade tensions with the U.S.

R&I: What’s your outlook on current trade relations between the U.S. and China?

Hank Greenberg: As to the current environment, when you are in negotiations, every leader negotiates differently.

President Trump is negotiating based on his well-known approach. What’s different now is that President Xi (Jinping, General Secretary of the Communist Party of China) made himself the emperor. All the past presidents in China before the revolution had two terms. He’s there for life, which makes things much more difficult.

R&I: Sure does. You’ve got a one- or two-term president talking to somebody who can wait it out. It’s definitely unique.

Hank Greenberg: So, clearly a lot of change is going on in China. Some of it is good. But as I said in the op-ed, China needs to be treated like the second largest economy in the world, which it is. And it will be the number one economy in the world in not too many years. That means that you can’t use the same terms of trade that you did 25 or 30 years ago.

They want to have access to our market and other markets. Fine, but you have to have reciprocity, and they have not been very good at that.

R&I: What stands in the way of that happening?

Hank Greenberg: I think there are several substantial challenges. One, their structure makes it very difficult. They have a senior official, a regulator, who runs a division within the government for insurance. He keeps that job as long as he does what leadership wants him to do. He may not be sure what they want him to do.

For example, the president made a speech many months ago saying they are going to open up banking, insurance and a couple of additional sectors to foreign investment; nothing happened.

The reason was that the head of that division got changed. A new administrator came in who was not sure what the president wanted so he did nothing. Time went on and the international community said, “Wait a minute, you promised that you were going to do that and you didn’t do that.”

So the structure is such that it is very difficult. China can’t react as fast as it should. That will change, but it is going to take time.

R&I: That’s interesting, because during the financial crisis in 2008 there was talk that China, given their more centralized authority, could react more quickly, not less quickly.

Hank Greenberg: It turns out that it is harder to change, because they have one leader. My guess is that we’ll work it out sooner or later. Trump and Xi have to meet. That will result in some agreement that will get to them and they will have to finish the rest of the negotiations. I believe that will happen.

R&I: Obviously, you have a very unique perspective and experience in China. For American companies coming to China, what are some of the current challenges?

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Hank Greenberg: Well, they very much want to do business in China. That’s due to the sheer size of the country, at 1.4 billion people. It’s a very big market and not just for insurance companies. It’s a whole range of companies that would like to have access to China as easily as Chinese companies have access to the United States. As I said previously, that has to be resolved.

It’s not going to be easy, because China has a history of not being treated well by other countries. The U.S. has been pretty good in that way. We haven’t taken advantage of China.

R&I: Your op-ed was very enlightening on that topic.

Hank Greenberg: President Xi wants to rebuild the “middle kingdom,” to what China was, a great country. Part of that was his takeover of the South China Sea rock islands during the Obama Administration; we did nothing. It’s a little late now to try and do something. They promised they would never militarize those islands. Then they did. That’s a real problem in Southern Asia. The other countries in that region are not happy about that.

R&I: One thing that has differentiated your company is that it is not a public company, and it is not a mutual company. We think you’re the only large insurance company with that structure at that scale. What advantages does that give you?

Hank Greenberg: Two things. First of all, we’re more than an insurance company. We have the traditional investment unit with the insurance company. Then we have a separate investment unit that we started, which is very successful. So we have a source of income that is diverse. We don’t have to underwrite business that is going to lose a lot of money. Not knowingly anyway.

R&I: And that’s because you are a private company?

Hank Greenberg: Yes. We attract a different type of person in a private company.

R&I: Do you think that enables you to react more quickly?

Hank Greenberg: Absolutely. When we left AIG there were three of us. Myself, Howie Smith and Ed Matthews. Howie used to run the internal financials and Ed Matthews was the investment guy coming out of Morgan Stanley when I was putting AIG together. We started with three people and now we have 3,500 and growing.

“I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.” — Maurice “Hank” Greenberg, chairman and CEO, C.V. Starr & Co. Inc.

R&I:  You being forced to leave AIG in 2005 really was an injustice, by the way. AIG wouldn’t have been in the position it was in 2008 if you had still been there.

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Hank Greenberg: Absolutely not. We had all the right things in place. We met with the financial services division once a day every day to make sure they stuck to what they were supposed to do. Even Hank Paulson, the Secretary of Treasury, sat on the stand during my trial and said that if I’d been at the company, it would not have imploded the way it did.

R&I: And that fateful decision the AIG board made really affected the course of the country.

Hank Greenberg: So many people lost all of their net worth. The new management was taking on billions of dollars’ worth of risk with no collateral. They had decimated the internal risk management controls. And the government takeover of the company when the financial crisis blew up was grossly unfair.

From the time it went public, AIG’s value had increased from $300 million to $180 billion. Thanks to Eliot Spitzer, it’s now worth a fraction of that. His was a gross misuse of the Martin Act. It gives the Attorney General the power to investigate without probable cause and bring fraud charges without having to prove intent. Only in New York does the law grant the AG that much power.

R&I: It’s especially frustrating when you consider the quality of his own character, and the scandal he was involved in.

In early 2008, Spitzer was caught on a federal wiretap arranging a meeting with a prostitute at a Washington Hotel and resigned shortly thereafter.

Hank Greenberg: Yes. And it’s been successive. Look at Eric Schneiderman. He resigned earlier this year when it came out that he had abused several women. And this was after he came out so strongly against other men accused of the same thing. To me it demonstrates hypocrisy and abuse of power.

Schneiderman followed in Spitzer’s footsteps in leveraging the Martin Act against numerous corporations to generate multi-billion dollar settlements.

R&I: Starr, however, continues to thrive. You said you’re at 3,500 people and still growing. As you continue to expand, how do you deal with the challenge of attracting talent?

Hank Greenberg: We did something last week.

On September 16th, St. John’s University announced the largest gift in its 148-year history. The Starr Foundation donated $15 million to the school, establishing the Maurice R. Greenberg Leadership Initiative at St. John’s School of Risk Management, Insurance and Actuarial Science.

Hank Greenberg: We have recruited from St. John’s for many, many years. These are young people who want to be in the insurance industry. They don’t get into it by accident. They study to become proficient in this and we have recruited some very qualified individuals from that school. But we also recruit from many other universities. On the investment side, outside of the insurance industry, we also recruit from Wall Street.

R&I: We’re very interested in how you and other leaders in this industry view technology and how they’re going to use it.

Hank Greenberg: I think technology can play a role in reducing operating expenses. In the last 70 years, you have seen the expense ratio of the industry rise, and I’m not sure the industry can afford a 35 percent expense ratio. But while technology can help, some additional fundamental changes will also be required.

R&I: So as the pre-eminent leader of the insurance industry, what do you see in terms of where insurance is now an where it’s going?

Hank Greenberg: The country and the world will always need insurance. That doesn’t mean that what we have today is what we’re going to have 25 years from now.

How quickly the change comes and how far it will go will depend on individual companies and individual countries. Some will be more brave than others. But change will take place, there is no doubt about it.

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More will go on in space, there is no question about that. We’re involved in it right now as an insurance company, and it will get broader.

One of the things you have to worry about is it’s now a nuclear world. It’s a more dangerous world. And again, we have to find some way to deal with that.

So, change is inevitable. You need people who can deal with change.

R&I:  Is there anything else, Mr. Greenberg, you want to comment on?

Hank Greenberg: I think I’ve covered it. &

The R&I Editorial Team can be reached at [email protected]