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Booming Retail: Managing Workers Comp Claims with Technology

As the retail industry grows, accelerated employee hiring and production means more accidents, injuries and workers comp claims.
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booming retail: managing workers comp claims with technology

Retail growth is back. Following a nearly 3% pandemic dip, retail industry growth hit almost 10% in 2021 and is expected to continue to grow, according to Oberlo. For businesses, this means accelerating hiring, more production, and additional workers on the floor—which could also mean more accidents, injuries and workers compensation claims.

The workers comp landscape has changed in recent years. The combination of new types of jobs, such as the gig economy, more small and medium-sized enterprises, and increasingly complex cases, like those related to mental health, is pushing the insurance industry to change its practices.

Inflation is playing a role, too. As prices for everyday items rise, workers demand higher wages from their employers, switch jobs to get higher pay or change careers entirely. This has a direct impact on workers comp, since switching jobs can impact the frequency of claims and higher wages impact the cost of payroll and insurance premiums for businesses, as well as the cost of medical treatment. 

“No other line of business is as directly affected by macroeconomic factors [as] workers comp," said Matt Zender, senior vice president of workers comp strategy, AmTrust Financial Services, in a recent webinar on inflation and workers comp.

With so much change occurring in the retail insurance market, claims organizations are being forced to adapt, and like other industries, one of the major ways they're doing this is through technology.

Leveraging Technology as a Claims Review Solution

More than 2 in 3 (67%) of Canadian, American, and Australian workers comp organizations (WCOs) indicate that they expect more than 80% of their claims to be triaged, managed, and assigned with no manual intervention in the future, according to Deloitte's “The Future of Workers' Compensation" study.

To get to the future of no manual intervention in workers comp claims, Deloitte researchers suggest adopting a risk-based claims classification policy. Low-risk cases—where recovery is expected, such as sprains, strains, or bruises—can and should be automated to involve minimal human decision-making. This could potentially refer to up to 80% of cases, which could be dealt with using standardized return to work plans to ensure consistency. The remaining 20% of cases—those involving uncertain or limited recovery—would be processed manually.

The results of these tech-driven solutions can mean lower costs for insurers, a faster processing time, and a more nimble organizational structure designed to quickly adapt to the needs of a changing global workforce. Artificial intelligence (AI), which can automate routine tasks and augment decision-making, also plays a critical role.

Artificial Intelligence

Much of the paperwork required by insurers, WCOs, and healthcare providers is unstructured medical data like case reports or legal documents that would normally need to be processed by hand. While tools like AI don't replace the human element, they can be used to automatically index, search and tag this data. Even in cases where human intervention is required, medical document processing can be done more quickly, and with fewer errors, when AI is involved.

Accelerated hiring, returning economic growth, an aging population, and other macroeconomic factors are pushing the insurance industry to adapt to the needs of a changing workforce. Many insurance providers, agents and claims organizations are betting on technology to help them stay ahead of the times. Is your insurance firm leveraging technology to support digital-first practices in the claims and medical records review process?

Jenna Earnshaw is the head of revenue at Wisedocs, the artificial intelligence platform that enables insurance, legal, and independent medical evaluation firms to review medical records with ease.

Monday, November 7, 2022
Workers Comp