In March 2020, Origami hosted a webinar “Transforming Your Workers’ Compensation Claims Organization with Digital Engagement.” Led by Scott Plummer, Head of Strategy, Core Solutions, and Chris Bennett, President, Core Solutions, the presentation highlighted how claims departments can leverage new digital pathways to drive customer engagement.
Challenges of Coordinating Multiple Stakeholders in Workers’ Compensation Claims Administration
Scott Plummer began the webinar by speaking about the challenges of coordinating communication channels across the various stakeholders who are responsible for managing a workers’ compensation claim—the injured worker, facility supervisor, medical worker, and claims adjuster. Use of outdated communication channels like fax, mail, and phone are inefficient and can lead to a frustrating back and forth. This has claims loss ramifications—claims stay open longer, injured workers don’t get the treatment they need and are therefore more likely to litigate, potentially increasing costs.
Plummer also spoke about how broader consumer trends such as the demand for real-time communication and personalized engagement is impacting the business world, as well, citing a Salesforce study that 94% of business users want better access to information. While workers’ compensation claims are more complex than an Uber ride to the airport, some of that demand can be met and communication streamlined with more modern channels, such as mobile, self-service digital portals, SMS, and secure email.
Digital Engagement Best Practices Illustrated Through Claim Intake, Adjudication, and Payment
After Plummer highlighted the need for modern communication channels, Chris Bennett dove into some of the technology solutions that can be leveraged throughout the claims journey—from intake to adjudication to payment—to improve efficiency and increase the satisfaction of claimants. For example, Bennett outlined the ways in which initial intake can be made more efficient by giving injured workers and risk managers access to a self-service portal for filing claims.
To drive customer satisfaction, once a claim is entered via the self-service portal, claimants can be notified of submission and given access to their claim. And to drive operational efficiency, upon submission, a claim can be auto-assigned to the correct adjuster based on specific details such as claim complexity and the experience and specialty of adjusters.
When beginning to work a claim, adjusters can leverage technology and improve communication between the three-point contact between the medical worker, injured worker, and risk manager. Examples include sending texts or email to an injured worker or supervisor for additional information, or the ability for healthcare workers to access information via a web-based portal. These communication channels can also remain open to notify an injured worker of payment.
Importance of Data and Analytics
The value of having a well-thought-out solution to real-time data values (both on the front-end and in reporting), as well as the importance of predictive analytics, was also emphasized. As part of this discussion, Plummer also took time to focus on automated alerts and persona-specific access to dashboards and self-service digital portals.
For large commercial insureds, consider how to best personalize and automate the level of information shared during the claims adjudication process. With the right solution in place, each key account can define special handling of their claims.
Account-specific business rules managed by business users allow for a level of service that is very specific to the preferences of the insured but is also fully automated. For example, business rules would trigger email for all new general liability claims and text alerts for workers’ compensation claims as they reach $2,000 in reserves. More sophisticated aggregated alerts could fire based upon a predefined threshold for number of injury events in a specific location, which can help support loss control efforts while driving policyholder satisfaction.
Result of Digital Engagement
If done correctly, improved engagement of the stakeholders involved in the adjudication of a workers’ compensation claim can lead to all parties getting the right information at the right time. As a result, this can contribute to:
- Increased Stakeholder Satisfaction
- Streamlined Processes
- Operational Cost Reduction