As industry headwinds like social inflation, regulatory changes, and talent challenges continue to shift, carriers are under increasing pressure to navigate complex claims and deliver improved outcomes. At the same time, advancements in technology are redefining how many organizations approach the claims management process from start to finish. Gallagher Bassett’s (GB’s) Irina Simpson, EVP — Workers’ Compensation, and Jon Stambaugh, SVP — Carrier Practice, discuss new challenges shaping claims management and how GB continues to provide a strategic edge with our dedicated team of claims professionals, ongoing investment in innovative technology, and commitment to achieving superior outcomes for insurance carriers, managing general agents (MGAs) and program administrators (PAs).
As the industry evolves, where do you see opportunities for GB to deliver a competitive advantage?
Irina Simpson (IS): Being an organization that is global and has many specialties across industries positions us to respond to developing trends quickly and effectively, even as our customers are impacted by industry-wide changes.
Our holistic approach to claims management also plays a key role. We provide tailored solutions for pre-loss, helping our clients prevent claims from happening in the first place. That can be vital, depending on which line of business we’re looking at.
When it comes to claims handling, that’s where we can bring very strong expertise. We have over 4,000 claims professionals at GB with line of business and industry-level expertise, whether we’re talking about workers’ compensation (WC) broadly or regional and jurisdictional expertise. The way we combine that institutional knowledge with our technology and innovative solutions is how we provide superior outcomes to our clients and partners.
The final part of our approach is being able to inform our clients, using analytics, about what we have learned and how we can help them do better in the future.
Jon Stambaugh (JS): No matter how the carrier landscape changes, a true differentiator for us lies in laying the groundwork for successful long-term partnerships. What sets GB apart is our dedication to getting the fundamentals right, whether it’s something as small as returning a call or as comprehensive as delivering high-quality and in-depth analytics.
Our success partnering with carriers and MGAs/PAs begins with our unwavering commitment to these markets. With dedicated teams in our claims operation, client services division, and business development group, GB’s Carrier Practice is fully dedicated to supporting carriers’ goals, serving as an extension of their in-house teams, and enhancing their overall claims and risk management strategies.
What are the main claim challenges that carriers and MGAs/PAs face, and how does GB help address them?
JS: Carrier claims leadership faces several headwinds, including talent acquisition and retention, outdated IT systems, and the need for innovation to enhance policyholder experience and provide claims leadership with actionable performance insights. Additionally, developing expertise to support new products and services is increasingly critical as carriers expand their offerings.
As a committed partner, GB is equipped to address these challenges and offer enhanced support for our carrier clients. Leveraging data-driven insights and AI-powered tools, we assist with informed decision-making both at the individual claim level and across entire programs/portfolios. Our customized claims management solutions are designed to mitigate current challenges and effectively reduce a carrier’s total cost of risk.
IS: We’re seeing a higher frequency of WC claims from low-tenured employees. Oftentimes individuals may have been hired during staffing shortage and may not have received appropriate safety training resulting in injuries. We work closely with our carrier partners to ensure that proper claim evaluation procedures are followed from the onset of the claim process, clinical interventions are applied to ensure early support, and all of the appropriate resources are utilized to ensure that the treatment provided is reasonable, necessary, and related to the compensable claim at hand. This approach, along with technical expertise and jurisdictional prowess of our claims teams allows us to bring early resolution to these files.
On another front, there have been signs pointing to rising severity in catastrophic claims. A partnership with the right claims management firm can play a critical role in identifying and applying the right resources to evaluate, plan, and mitigate them effectively. At GB, we emphasize the importance of focusing on material changes within the claim trajectory and aligning file actions accordingly by timely and accurate reserving to ensure financial preparedness, the early utilization of CAT clinical services to address complex medical needs, and the implementation of strong bill review and re-pricing protocols to manage costs efficiently. By working closely with our clients, we analyze high-severity claims, develop collaborative action plans, and leverage all available tools and expertise to deliver sustainable, long-term solutions.
In today’s competitive landscape for specialized talent, how does GB attract new talent and build a resilient team?
IS: While attracting talent is key, it’s even more important to retain that talent. In today’s environment, claims professionals are looking for companies that will listen to them and help them achieve work-life balance because they know how difficult their profession is. They know that there are going to be days where they’ve got a lot going on, so they need a culture that will continuously work on improving their experience by building new processes, investing in technology, and prioritizing learning and development.
And that’s what we do at GB. We invest in our talent, and we invest in frontline leadership to make sure they’re supported. Our leaders create an environment where claims professionals feel heard, know that they can lean on each other, and can see their path toward career advancement.
JS: As an organization that has an unparalleled track record for growth, GB has built a robust training and development ecosystem aimed at building a long-term home for future leaders within the claims and risk management industry.
GB has embraced the concept of building our own talent pipeline and has invested heavily to ensure we are poised to maintain our leadership position in the industry. This includes our enhanced Emerging Talent INVEST Program, our IN2GB intern program that builds on our sustainable partnerships with colleges and schools that have diverse student populations, and other initiatives. We have built an ongoing feedback loop in which we actively engage with our frontline claims professionals to understand how we can empower them for long-term success. This feedback cycle is tied to a strategic initiatives team that is continuously refining processes and technology, enabling GB team members to focus on high-level tasks, fostering a people-first culture, and ultimately creating a better experience for our team members.
How does GB’s continued investment in technology, from enhancing our data and reporting capabilities to utilizing AI and decision-support tools, support its dedication to service excellence?
IS: Over the last five-plus years, GB has been carefully refining our AI road map, reflecting on our approach and our goals with technology. Through thoughtful planning, our investment in technology has been made in a way that supports and enhances the claims process, particularly the work of our Resolution Managers (RM). Technology isn’t the leading factor—it’s human decision-making that’s still front and center. Our tools help RMs focus on what matters most in the claims process: making informed decisions to expedite claim resolution. RMs new to a claim desk often face dozens or even hundreds of pages of information associated with a claim that must be reviewed and synthesized before a decision can be made.
When it comes to AI and the tools that we have built for that space, they all started with finding ways to support our claims professionals and drive outcome improvements. With something like Claim Summarizer, for example, our GenAI tool streamlines the claims review process by generating detailed summaries across nine key categories, including coverage, medical and financial details, and status.
The bottom line is that these are decision-support tools. They create efficiencies and enhance how we work, helping claims professionals spend more time thinking critically as opposed to completing repetitive administrative tasks.
JS: Like everything we do, our approach to AI is guided by our core mission to help our clients prevent, manage, and overcome the impact of risk.
That’s why our AI technologies are built to empower our frontline claims professionals to make informed decisions and deliver better outcomes. Tools like Claim Summarizer, Document Insights, and Email Sentry take low-complexity tasks off the table so that GB claim professionals can prioritize high-leverage tasks and claimant interactions that improve claimant experiences and drive real impact.
To find out more about how GB can help you navigate today’s shifting industry landscape, reach out to our team today.
