Researching Predictors of Claimant Behavior

The healthcare industry has made great inroads into disease management with the use of evidence based medicine. This has been extended recently with the use of additional data capture tools applied during the healing process to understand the effect on the patient of the treatments applied as well as the medications prescribed.

We need to apply this same approach in the disability insurance industry, to focus on return to work and to research the predictors that influence claimant behavior.

Recently there has been significant progress in understanding the reasons why people become disabled after an injury or illness, as well as the predictors of return to work from disability.

The general consensus is that the medical condition itself and the associated clinical recovery estimates provide limited insight and explain only a small part of claimant outcomes, including time taken to return to work.

Psychosocial factors, coping strategies, available resources, and workplace constraints are just a number of examples of dimensions not captured by a medical diagnostic code, but which strongly predict return to work and other claimant outcomes. These findings have emerged largely from academic research, and not from activities within the insurance industry where there continues to exist a research-practice gap.

There is a need to integrate these research practices with claim analytics to get a more comprehensive picture and to better inform claim management.

The Claim Lab is looking for partners to assist with this research, if you are interested in hearing more about working with us to innovate these practices, please send us an email.

The Claim Lab  – Email us at  info@claimlab.org