How Data Intersects With Operational Health for Stronger Claims Outcomes

The rise of analytics has many worried it will replace the genuine value brought by the people in your team, but it’s possible to leverage data, analytics and automation to actually empower your people and take your business further.
 Dawn Griffin, Carrier Practice Claims Operations Leader – Gallagher Bassett, talks to how carriers can leverage the talent in their business through use of technology.

Everyone in the industry knows that bringing a claim to resolution often relies on timely access to medical care, and for more complex or contentious claims, the court systems. This is where data can intersect with the operations of your business to deliver stronger outcomes, through increased collaboration, smart software and automation that empowers the critical personal touch that every claim needs.

Our growing comfort with video conferencing enables your business to have more frequent and personal touchpoints with your employees, improving engagement and morale. This ability to collaborate confidently can lead to stronger outcomes through the sharing of ideas and experiences to feed effective claim resolution strategies.

This collaboration is crucial in our ever-changing market, which is why access to the right insights and analytics tools is essential for your team to anticipate fluctuations in claim volumes and obstacles ahead. At GB, we utilize our award-winning RMIS platform LUMINOS to guide resolution managers through a file from assessment to closure. Through this platform, our team of claim professionals are empowered to make informed, effective and strategic decisions on a file, in record time.

This decision support tool ensures we can harness the collective expertise of our organization to evaluate reserves, select providers or counsel, and consider intervention and settlement strategies. We have taken this tool one step further by developing our Clinical Guidance solution, which helps identify opportunities for clinical intervention on Workers’ Compensation claims. Through this, we are able to use analytics to detect what early clinical interventions can result in superior outcomes. We can then compare the outcomes of this file against like-for-like claims across the millions of claims handled by our team, to confirm the anticipated impact and reward.

This type of automation within the claims management process will save your business from the errors and fatigue associated with administration. We have seen significant returns for clients who have used automation for low-moderate frequency, higher severity claims. This is where the majority of loss dollars are often concentrated, and even modest improvements in the time spent on these files can drive material outcomes for our clients. By automating the more routine or administrative aspects of the claim process, our claim professionals are able to focus on what brings claims to resolution – building trust with claimants, facilitation of resolution/return-to-work with clients and engagement with physicians, defense counsel and other providers.

Ultimately, automation and data ensure your business is operating with integrity and quality. It allows you to manage risk in a research-driven way, backed by highest-quality information to support targeted loss control efforts and more effective underwriting of risk and claim portfolios.

While it might sound like we have invested heavily in technology, which we have, we also do not undervalue the fact that claims are a deeply personal experience. It is our team’s core belief that claims require sincere, caring and professional interactions. Technology allows us to enhance the claim experience and personal touch, not to disintermediate it. By removing administrative tasks, a claims professional is able to have more time to speak with an injured claimant. If that injured claimant can then check on the status of their indemnity payment through a mobile app, it’s more time for the claims professional to engage with the employer on return to work strategies.

We provide analytic tools to our clients to help them identify opportunities in their portfolio, and give our team more time for robust claim strategy discussions to benefit claimants and the client’s total cost of risk.

To find out how GB’s technology suite can reduce your total cost of risk, connect with our team today.

Dawn Griffin

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