You Won’t Believe How Much Potential Insurtech Has in WC Claims Management

Technology isn’t revolutionizing workers’ comp just yet, but machine learning, robotic automation and new communication platforms are attracting a lot of investment dollars.
By: | November 29, 2018 • 2 min read

“Last year I talked about Insurtech as disruptive technology. This year I’m talking about Insurtech as an enabling technology,” said Jeffrey Austin White, SVP & product manager, workers’ compensation, Gallagher Bassett.

White will be presenting the session “InsurTech, Artificial Intelligence and New Technologies Impacting the Claims World” at the National Workers’ Compensation and Disability Conference & Expo in Las Vegas this Thursday at 10:45 a.m. in the Mandalay Bay in Las Vegas.

“I changed my tone, because the industry changed its tone,” White added.

Jeffrey Austin White, SVP & Product Manager, Workers’ Compensation, Gallagher Bassett

That is to say, the industry has begun investing heavily in new technologies focused on improving the customer experience and bringing an element of automation to underwriting and claims processes. Some standout solutions in the commercial insurance industry include straight-through claims processing, wherein simpler claims can be filed, approved and paid in a matter of minutes without a human even touching it.

In workers’ comp, claims are never that simple. But, claims mangers can still leverage some pieces of the technology to make their lives a little easier. Robotic process automation can take over rudimentary, repetitive tasks like moving and renaming files and managing invoices, which frees up adjusters to do more important work like tracking prescribing patterns and managing care.

“Technology should enable adjusters to focus on more critical issues, like making sure claimants are getting the best quality of care and handling the claim to best of our abilities, versus getting caught up in  the minutiae of all these other tasks,” White said.

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Machine learning apps may also help to predict high risk claims and guide action on them.

“We’ve seen this in cases where opioids are involved. More decisions in future will be based on advanced analytics; data gets us more information in a more timely manner,” White said. “Artificial intelligence can help make decisions on tough cases, but there will always have to be boundaries and oversight on that.”

Texting platforms can also address a common pain point: communication between adjusters and claimants. “People don’t feel comfortable answering phone calls from numbers they don’t know. Technology can help improve communication,” White said.

Of course, any technologies built to facilitate communication with consumers must adhere to state and federal regulations, which often require an opt-out feature. Nonetheless, a large proportion of Insurtech applications will be built for mobile devices.

“We are dependent on our mobile phones, and the industry has to leverage mobile tech to connect with consumers. Insurtech firms are focusing on better value for the money, integration between social and financial worlds, and timely and efficient service.” &

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

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