AI is coming for claims management – here's how to prepare your teams

AI is coming for claims management – here’s how to prepare your teams | Insurance Business America

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AI is coming for claims management – here’s how to prepare your teams

Majority of firms believe it can give them a competitive edge

If there was one phrase that’s dominated the past year, both professionally and societally, it has to be “generative AI”. According to KMPG’s Generative AI Survey, results reveal that 77% of insurance executives believe AI will have a more significant societal impact within the next three to five years than any other technology. What’s more, 84% of firms, including insurers, say that investing in this new AI will give them a competitive edge.

On the claims management side of things, AI has had an almost unprecedented impact – speeding up claims processes to an electrifying speed. Speaking to IB, Michael Combs (pictured), president and CEO of CorVel, said that this increased efficiency had enabled adjusters to gather more crucial information on claims and helped injured workers return to their jobs swiftly.

“With the application of technology, decision-making processes have evolved,” said Combs. “Generative AI has helped reduce what was a lag time of days, weeks or months, collapsing the feedback loop and allowing our partners to look at historical data to understand what happened and, more importantly, what do we do about it.”

‘The sheer number causes difficulties’

It’s CorVel’s management dashboards that provide immediate insights. This immediacy is crucial for stakeholders, enabling them to identify areas of opportunity and make timely decisions.

“Our dashboards are all real-time; you’re not waiting for the end of the month to gather data,” he said. “Most of the information is instantaneous, once again compressing the time loop to get feedback and to allow decision-making to happen immediately.”

Combs acknowledged, however, the challenges of managed care integration and the complexity faced by clients working with multiple vendors.

“One recurring message is that while each integration isn’t particularly challenging, the sheer number of them causes difficulties,” he said.

To alleviate this burden, the company proposed a hub model, where CorVel acts as the central point of integration. This approach simplifies the integration process for clients, allowing them to focus on optimizing their programs.

‘There are appropriate considerations when using this technology’

And, looking ahead, Combs is optimistic about the role of technological innovation in the insurance industry. CorVel’s strategy involves laying a broad technology platform to leverage advancements from various providers. This foundation is designed to be agile, responding to both technological evolution and business needs.

“I expect we’ll see the pace of change increasing,” Combs said. “We want a foundation that’s able to make use of the information, leveraging the technology advancements as they become available.”

Once again, it’s AI that’s poised to play a significant role in this evolution, with Combs believing we are only at the beginning of understanding its potential. However, he stressed the importance of the intentional and transparent use of technology.

“There are appropriate considerations when using this technology – first and foremost is the protection of data and ensuring that the customers’ data is siloed and that we’re being very intentional with our use,” Combs said.

The future of generative AI within CorVel is not limited to current implementations. Combs envisions its expanded use across various operations. The goal is to use technology to augment, not replace, the work of CorVel’s team members. By minimizing time spent on repetitive tasks and maximizing engagement with injured workers, CorVel aims to drive optimal results.

“I expect that there will be expanded use in business in general, and that’s certainly aligned with how we at CorVel are looking at it,” he said. “[It’s about looking at] how we bring technology to bear to elevate the work that our team members are doing.”