August 2022 – Mining for Hidden Gold

In some of our previous blogs we have talked about how psychosocial insights are beneficial for claim outcomes, case manager job satisfaction, and overall claims departments’ organizational health for several reasons.

As anyone in the business world knows, if a ‘prospective’ project, strategic initiative, acquisition of a new tool is to be undertaken, subjective benefits and positive examples are not enough for that initiative to make the cut. In most organizations, the only initiatives that will ultimately be undertaken reflect a quantifiably positive financial impact.

Last month’s blog discussed several characteristics of a successful initiative, including the need to benchmark the current state, quantify potential positive gains, measure results, and to demonstrate the overall benefit. When deciding to invest in the ability to effectively mine psychosocial data (or other capabilities), decision makers are looking for (previously hidden) gold.

There are many potential metrics a claims organization can consider when formulating a cost benefit/ROI analysis. At the Claim Lab we understand the importance of these analyses and have seen a range of benefits as a result of using analytical projects.1. Reduce Durations – The big headline is reduction in claim duration, that’s goes straight to the bottom-line, and all the subsequent points feed into this key financial benefit.

2. Complicating Factors – Good data helps spot the complex claims, before they become complex, where less serious diagnosis or injuries can result in long duration claims… This is likely caused by those “psychosocial factors” that complicate return to work… more on this next month!

3. The Right Process – More efficient handling of claims, by ensuring the claim follows the best process from the outset, handled by the most appropriate skillset in your organization.

4. Early Intervention – By collecting data at the start of the claims process we can act early to address the issues identified.

5. Improve Pricing – We can better support actuarial science with improved pricing and underwriting data, and better reserving.

6. Enhanced Customer Experience – This is better for the employee and better for the employer. With greater care taken to understand issues, not just injuries or illnesses. Greater empathy leads to better results and less litigation.

This is not a comprehensive list of performance categories, more of a Top 6 that might be considered, but these nuggets will hopefully provide a framework to get started on your search for gold!

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