Advanced data analytics and predictive modeling has become one of the most important tools claims organizations have at their disposal to achieve the best possible outcome on each claim... In fact, in citing a recent study, Business Insurance wrote, “High-performing workers compensation claims organizations use predictive modeling eight times more frequently than firms with less success in closing claims…1”
At Beacon Mutual, we have invested heavily in developing integrated advanced, predictive analytics into our claims handling. In fact, our proprietary models start analyzing claims data the moment a claim is reported and are used to assign each claim to the adjuster best suited to handle it. A daily analysis of each open claim identifies those claims that show signs of being at a higher risk of complication in medical treatment or return-to-work.
According to David Blair, Vice President of Claims, “To deliver a great outcome for Beacon customers and their injured employees, strong decision-making and advocacy for the injured employee’s recovery is still needed to get the best result. Predictive models are tools that help inform our claims experts by alerting them of risks early, so they can craft a claims handling strategy to mitigate those risks.”
While each claim is unique, the information provided by our models may prompt an adjuster to take any number of steps to improve the chance of a successful claim outcome. These steps may include engaging one of our nurse case managers, seeking a second medical opinion or arranging for a vocational rehabilitation services, among others.
Our goal is to help employees recover from their work injury and return to work as quickly and safely as possible to minimize the impact of an on-the-job injury to our customers’ businesses. Advanced analytics and predictive modeling help us meet that goal.