From Reactive to Proactive: The Shift Defining Risk Management

For years, the risk management industry has been defined by its reactions to what’s happening around it. In highly regulated environments, that’s expected. We must move strategically and with caution, because the care, recovery, and protection of injured individuals and impacted parties depend on it. But we’ve reached an inflection point. AI adoption, particularly agentic AI,  is accelerating across both sectors, driving innovation, improving efficiency, and delivering better outcomes for all stakeholders.

In 2026, we’ll see a decisive shift from reactivity to proactivity, spanning technology adoption and care management to risk identification and risk mitigation. Across every dimension, our mission remains the same: to enable more effective case management and deliver high-quality, personalized care at scale.

The following are a few predictions from CorVel’s leadership team that encapsulate this shift and reflect the forces shaping our industry today.

Prediction 1: Agentic AI will dramatically accelerate the reduction of administrative burdens, with human expertise and intelligent systems emerging as the winning combination

In 2026, workers’ compensation and liability will shift toward dramatically reducing the administrative burden created by years of expanding data and reporting demands. Agentic AI will accelerate this change by enabling faster software development, streamlined workflows, and more actionable insights for claims professionals. While some remain cautious about new technology, businesses must evolve to stay competitive. The most powerful transformation will come from combining human expertise with intelligent systems that amplify, not replace, judgment and creativity. This synthesis of people and technology will define the next era of claims management.

– Michael Combs, President, CEO, and Chairman

Prediction 2: The human-centered approach to innovation will prevail, enabling empathy and strategic thinking to take center stage in claims management

AI has evolved from a promising tool to an essential partner in claims management, building on the rapid adoption and value-based care successes of 2025. The key differentiator lies not in the technology itself but in how AI enhances human connections, facilitates deeper conversations, and uncovers hidden barriers to recovery. This human-centered approach to innovation enables claims professionals to dedicate more time to complex cases that require empathy and strategic thinking. The industry is also shifting from reactive data analysis to proactive, predictive intelligence. These advanced capabilities identify severe claims early and enable strategic resource allocation, delivering personalized care at scale.

– Sarah Scott, Executive Vice President, Product and Corporate Services

Prediction 3: AI-driven early intervention will fuel the shift from reactive claims handling to proactive risk identification

This evolution represents the industry’s most significant opportunity since managed care emerged, with success measured not merely by claims processed, but by injuries prevented and lives improved. The critical window for intervention lies within the first 30 days following an injury. Early identification and targeted clinical support yield lower costs and faster resolutions.

This transformation isn’t about replacing healthcare professionals with algorithms. Instead, it’s about empowering nurses and clinicians with AI-enhanced capabilities. While artificial intelligence handles complex data analysis, healthcare providers can focus on what they do best: delivering compassionate patient care.

To succeed in this new paradigm, organizations must invest in integrated platforms that seamlessly connect claims data with medical records, train staff to collaborate effectively with AI tools, build strategic partnerships with providers who understand early intervention protocols, and develop metrics that prioritize prevention over simple claims closure. Companies that master this balance between advanced technology and human-centered care will achieve dramatic improvements in both clinical outcomes and financial performance.

– Karen Thomas, Vice President, Clinical Solutions

Prediction 4: Advancements in technology and the elimination of silos in managed care will drive superior outcomes and expedited return-to-work  

Advancements in technology are driving efficiency and supporting the shift from reactive claims management to proactive risk mitigation. Predictive analytics now identify potential issues before they escalate, while AI and automation streamline bill processing, integrate data across platforms, and accelerate decision-making—ultimately benefiting injured workers.

Tomorrow’s most successful programs will eliminate traditional silos across managed care—integrating these functions leverages interconnected systems to achieve superior outcomes and expedite return-to-work timelines.

Industry leaders are recognizing that sustainable success requires balancing cost containment with enhanced patient experiences. They deploy automation for routine tasks while preserving the human connection essential for meaningful recovery. As mental health claims and value-based care models expand, the industry must adapt by integrating holistic care approaches, emphasizing early intervention and data-driven clinical oversight.

– CJ Cypcar, Vice President, Network Solutions & Product Integration

Prediction 5: The organizations that understand liability management extends beyond claims efficiency will emerge as winners

In 2026, the liability industry must shift from reactive to proactive claims handling and risk prevention. By focusing on completing prompt and thorough initial investigations, in conjunction with integrated clinical reviews and predictive modeling, insurers can identify high-risk cases before they escalate to litigation. This approach, which combines advanced claims management systems with embedded features, can significantly reduce litigation exposure. Risk managers who delay adopting these integrated solutions face not only increased costs but also fundamental threats to their programs’ viability. The organizations that will succeed in 2026 are those that understand liability management extends beyond processing claims efficiently; it requires mitigating the probability of catastrophic verdicts through strategic, data-driven intervention.

– Candy Hammond, Liability Product Manager

Prediction 6: Intelligent automation will create more space and time for claims professionals to focus on their most critical responsibility

Advanced technology will empower claims professionals to focus on the most critical responsibility: helping injured workers recover and return to productive employment. Intelligent automation will streamline routine administrative tasks from medical record retrieval to data entry, creating valuable time for meaningful human interaction and personalized care.

Predictive analytics will enable the claims team to instantly identify high-priority cases requiring immediate intervention, optimizing caseload management and improving outcomes. Success in this new era won’t come from replacing human expertise with machines, but from equipping claims professionals with sophisticated tools that enhance their capabilities.

Ultimately, technology alone doesn’t heal injured workers; genuine communication, clinical insight, and collaborative care management are what drive recovery.

– Lara Heal, Vice President, Network Services

Prediction 7: AI will evolve from tool to active decision-making partner, fundamentally redefining claims handling in 2026 and igniting critical regulatory conversations

The AI transformation will accelerate beyond documentation, fundamentally redefining claims handling and establishing new operational standards as regulations struggle to keep pace. AI will evolve from a supportive tool to an active decision-making partner, a shift that will ignite critical discussions about appropriate boundaries and oversight requirements. While state regulators will introduce legislation to govern AI’s expanding role, technological advancement will inevitably outpace regulatory frameworks, compelling the industry to develop self-governance standards during this transitional period.

The most significant impact won’t stem from the technology itself, but from how it empowers claims professionals to prioritize what matters most: fostering trust and building meaningful relationships with injured workers. Organizations that successfully balance this dual approach —leveraging AI for efficiency and precision while investing in personal interactions—will achieve superior outcomes and reduce costs. Conversely, companies that resist innovation or cling to outdated practices risk obsolescence as the industry undergoes more transformation in the next five years than in the previous three decades.

– Jeff Gurtcheff, Chief Claims Officer

The technology foundations are in place, and the path forward is clear. The shift has already begun. In 2026, the risk management industry will be defined by readiness, not reaction, guided by a human-centered approach to innovation and claims excellence. &