Resolving claims in less time and with better outcomes must involve predictive analytics and human insight.

Through partnering these two factors, carriers can accelerate the claims lifecycle and see a return on their investment.

The many factors that influence a claim’s lifecycle – such as severity, complexity, likelihood for litigation - can be effectively predicted by analytic tools that can then feed into a claim professional’s informed judgement on a file. Our Carrier Practice team has stepped out below the process we take, and tools we implement, to help our clients achieve an accelerated claim lifecycle.

The first step we take with clients to understand the current state of their claim lifecycle and opportunities to accelerate this is to assess the complexity of their book.

This helps us identify what predictive analytics tools could be useful to support superior outcomes and decision making. Intelligent and efficient technology is an essential part of the modern carrier’s toolkit, and can help you make smarter decisions around benchmarking outcomes, reserving, predicting litigation, settlement opportunities and other key decision points.

For carriers wishing to see change in claim outcomes, we apply our award-winning Severity Mix Adjusted Rating Technique (“SMART”) methodology to develop meaningful benchmarks. While standard TPA benchmarking involves comparing client claim data to an entire book, or at best, data from similar industries. These traditional benchmarking activities lack the refined approach of our SMART solution, which uses a state-of-the-art claim complexity-rating algorithm to assess an extensive number of claim-level characteristics to predict severity.

We combine this tool with Waypoint, our predictive analytics platform that assesses the appropriateness of reserves and adequacy of the financial involved. Through this process, we eliminate the need for manual assessment and ‘gut feel’ response to claim severity and instead instill resolution managers with smart analysis to pick off low hanging fruit and aggressively pursue claim resolution.

Resolution managers are then able to accelerate the claims lifecycle and move on to the next file without unnecessary delay. This results in a better outcome for carriers, claimants and claims professionals.

Resolution managers who take advantage of these tools feel supported and empowered to make accurate decisions and are more motivated to address the next file on the list. This is a great outcome for all involved, and if you want to find out how Gallagher Bassett can help you accelerate the claims lifecycle – connect with our team today.

Blog Author

Jon Stambaugh

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