The Claim Analytics Opportunity Reports help our clients get the most out of disability claim scoring.
Our Opportunity Reports highlight claims where the actions and resources of the claim handler are most likely to have a positive impact on outcome. Typically this includes claims with a high potential for return to work as well as those with low potential, where pursuit of offsets is the more appropriate goal.
First step with Opportunity Reports – Clean-up
- Opportunity Reports are typically used by a small team to find opportunities for return to work in mature claims.
- Team may also work on mature claims with low return to work potential where they have not yet pursued an offset.
Second step – Maintenance
In the next step, maintenance, the scores are introduced to all claim handlers. The start-up team shows the claim handlers how to use the Opportunity Reports to highlight claims approaching their predicted duration. The goal is to manage claims with a high or low return to work potential in a proactive, timely manner.
Third step – Segmentation
The third step, segmentation, incorporates claim scoring into the ongoing management of all claims, for all claim handlers. In this step, the claim scores are used as a decision support tool to help claim handlers focus resources where they are most likely to have impact / improve return to work outcomes.
Opportunity Reports as a measure of success
Some insurers use Opportunity Reports as a means of measuring departmental success. As an example, they may track how many claims with high return to work potential go beyond their predicted duration, or how many with low potential persist without an offset.