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Industry Trends

How to Enhance Innovation in Workers’ Compensation

As technology rolls out faster than ever, workers’ compensation remains one of the slowest adopters, but why? Understanding the optimization processes may help organizational efforts toward modernization.

October 23, 2023

Discussions around AI, natural language processing, and chatbot technology are everywhere you turn, but how can the workers’ compensation industry take advantage of these latest innovations? Future advancements could potentially expedite policy verification, eligibility, claims intake and reporting, document validation, rules-based decisions, and automation of straightforward, low-dollar claims

Vice President of Client Engagement, Mark Walls, discusses a few steps to drive your business forward, avoid repetitive duplicative tasks, and allow your experts to focus their attention on meaningful work.

1. Stop allowing antiquated processes to impede progress.

Considering how long ago the industry began, it is important to acknowledge it was born out of a process and continues to be rooted in tradition. The longevity of this industry bears a legacy claims system with a large volume of data, and any changes made can be costly and challenging.

Workers’ compensation is the most highly regulated insurance industry, which can severely inhibit change. Everything from what, when, and how you pay an injured worker to the layout of a form is regulated. Several states still mandate that paper checks be mailed, preventing even the most uncomplicated innovations from occurring, like direct deposit or alternative payment forms.

2. Understand your organization’s areas of opportunity.

All organizations could benefit from being more technology-curious, assessing risk appetite and aversion, and resetting with their team and partners. Additionally, understanding the priority of investments will help drive business goals forward, but finding the right place to start implementing new processes can be one of the most challenging aspects of innovating. Ideally, more methods must be available, whether communicating with an employee or injured worker.

Injured workers seek transparency, eliminating frustrations throughout the claims process. Phone applications could provide immediate resolutions to problems that typically require endless phone calls. Employers need to discover methods to handle the large volume of workers’ compensation claims efficiently. Using AI and predictive modeling, all within the construct of a decision-making model can help move things along faster, providing employees with little to no claims background the ability to learn until they are more comfortable handling claims efficiently.

3. Ensure adopted technology meets enhancement criteria.

Technologies like AI allow employees to focus on more niche tasks without eliminating the human touch necessary to drive claims forward. As connectivity and machine learning become more refined and simulate a better experience, there will be a stronger willingness to adopt. However, before investing in any new technology, organizations should ensure it is improving three key areas, including:

  1. Efficiency – For example, when automating parts of the claims process, does it allow your adjusters and claims professionals to work on more important items?
  2. Effectiveness – Does it drive down the total cost of risk?
  3. Experience – What is it like for the injured worker using it? Is it compatible with goals pertaining to care and connection?

Digital roadmaps can provide insight into technology’s influence on your customer base, employee and injured worker experiences, and even regulators and attorneys. Unstructured data can be transformed through innovations like Natural Language Processing, which can assist in determining the best decisions for claims relating to utilization reviews, medical, and return to work.