Making Combined STD & LTD Products Work!

“Our experience of a combined STD & LTD product is that LTD transition is higher!”

“The problem with STD claims is that we have no time to work on them properly”

Managing STD claims is highly transactional, and carriers need to employ better tools to help focus claim managers on those claims that may transition to LTD.

There are many STD claims that, given the profile of the claimant and the nature of their condition, will be resolved well within the STD period. To identify such claims, insurers need to turn to the analysis of their claim data, and look at the profile of these claims historically.

“It’s all in the data!”

Once these claims are identified they should be put on an automated claims management track, either using a ‘Pay & Close’ approach or added to existing auto-adjudication rules within the claims management system.

The level of re-opens and over-payments need to be monitored to ensure that the parameters on the rules are set correctly.

“MORE time to manage claims at risk of transition.”

So what will STD claim managers do with all the time this will save them?

They can manage transitional claims, in other words, claims that have a risk of moving from an STD claim to an LTD claim. This is the single most important objective for an STD claim manager, helping people get back to work before the ‘disability mind-set’ is established, while they still have a job, and while they still have medical insurance.

The Claim Lab uses a segmentation approach to divide the claims into groups, given the characteristics of the claim. This uses an insurers own experience and an industry wide scale as input to an analytical scoring model, which then classifies new claims as they come in, real-time.

Typically we see that between 40-50% of claims can fit into the automated claim management classification, which may equate to 25% of a claim manager’s daily activity.

“It’s like having 25% more claim managers”

So the insurer will have 25% more resources to apply to the real problem that is managing claims at risk of transitioning to LTD.

Interested to hear more? Drop me an email at ibridgman@claimlab.org.