From the Editor's Desk
An Unexpected Antidote
Claims data turns up important clues that are helping to identify cases that could require early intervention.
- Patricia Vowinkel
- September 2018
Insurers receive millions of claims each year. Getting those claims managed and processed can be a difficult task involving extensive documentation, paperwork and time.
New technology and advances in data analytics, however, have begun to pay dividends.
In “The Data Antidote,” Best's Review looks at how the insurers are using workers' comp claims data to identify red flags and correlations that can serve as an unexpected antidote in the battle against the opioid epidemic.
The Hartford, for example, uses 25 machine learning models to scan workers' comp claims every night and analyze the data.
One of The Hartford's machine learning models looks for psycho-social flags. It searches text for indications that an injured worker might have social or psychological stressors that could affect recovery or lead to opioid addiction.
When it analyzed its claims data, The Hartford found that 11% of injured workers demonstrate these psycho-social flags, but those 11% account for more than 50% of claims costs.
The digital revolution is beginning to take shape in the life insurance business as well, where new systems are helping insurers respond to customers more quickly and cut costs.
USAA's life business, for instance, has reduced the time it takes to process and pay nondigital claims by more than 33%, from an average of 45 days just a few years ago to 25 to 30.
In “Claiming Progress,” Best's Review speaks with executives from USAA's life operations and MassMutual about the digital revolution and the impact on life claims management, as well as regulatory challenges and other issues such as the opioid epidemic.
While technology upgrades are needed, the human touch is still critical.
Thousands of claims adjusters, for instance, were on the scene last year after hurricanes Harvey and Irma hit to help people who had lost their homes file claims with their insurers. Many adjusters, however, are approaching retirement age. “Making Adjustments” focuses on the impending shortage of claims adjusters and how the industry is responding.
The September issue of Best's Review also includes a focus on reinsurance with our ranking of the Top 50 Global Reinsurance Groups.
September is also Life Insurance Awareness Month. Life insurers use the month to call attention to the financial needs of individuals and families. This issue includes A.M. Best's ranking of the top U.S. life/health insurers.
A final note. Best's Review is now available online in a new reader-friendly format. Go to www.bestreview.com to read and share articles and other Best's Review content. Subscribers to the print edition will continue to receive the magazine and also have access to enhanced content not available online. Let us know what you think.