Tech Innovations in Claims: A Discussion on People, Process and Technology in Workers’ Compensation

At the 2024 Workers Compensation Institute conference in Orlando, a panel discussed Tech Innovations in Claims. The panel included:

• James Bentham – Chief Executive Office and Co-Founder, Terra
• Greg Hamlin – Senior Vice President and Chief Claims Officer, Berkley Industrial Comp
• Cyndee Morton – Chief Operating Officer, Safety National

What has been the most significant technological advancement in workers’ compensation in the past few years?

• Use of data. We have access to so much data that can help us to do so many different things.
• Digitization of records. The days of paper claim files are essentially over and everything is scanned and stored in the cloud. This allows us to access unstructured data by using AI to read and analyze documents.

How well does our industry understand the technologies currently available?

• Not very well. The insurance industry is slow to change. There are always concerns about costs and data security when it comes to innovation. The industry tends to attract people who like systems and processes because those things drive the industry.
• Workers’ compensation is highly regulated which makes innovation challenging. Stability and predictability are the key to the insurance industry. Legacy systems are difficult to modify and integrate new technology. It is safer to be a fast follower than on the leading edge when it comes to innovation.

How do you see self-reporting and QR code reporting impacting claims?

• The faster claims are reported, the faster solutions can be deployed.
• The top challenge with late reporting of claims is employers’ understanding of the benefits. Medical only claims have a very minimal impact on an employer’s mod for calculating rates and the carrier can handle those claims cheaper than the employer in-house.

As our dependence on technology grows so do our vulnerabilities. What lessons can we learn?

• Make sure you have a great incident response plan in place BEFORE bad things happen.
• Data security is so important given all the sensitive data within the workers’ compensation industry.

What is your take on AI and how it has been utilized by the industry?

• Predictive analytics are one of the best examples of how machine learning can be used. These allow carriers to better spot red flags that could lead to increased claim costs.
• AI can enhance the ability of adjusters to do their jobs, not replace adjusters. It can make adjusters more efficient and perform time-consuming, mundane tasks so that the adjuster can focus on the bigger issues.