The workers’ comp marketplace is highly competitive, with private companies operating alongside state-funded entities. Economic shifts such as unemployment rates, interest rate fluctuations, and payroll reductions affect the marketplace. Staying profitable despite mandated rates and benefits requires creative ways of improving operating efficiency. Insurers are focusing their improvement efforts on areas like distribution, claims, and billing.
Distribution
Private carriers generally offer workers’ comp via independent agent, while state funds use direct distribution. But more carriers have started to offer workers’ comp online, either stand-alone or as part of a commercial package. Online agent portals with capabilities for front-end submission and loss run information are increasingly common. A growing number of carriers are also building out this functionality into customer portals.
Customer portals are a way to gain efficiency, cut costs, and meet customer communication preferences. New portals include functions like payroll/loss reporting, bill inquiry and payment, certificate tracking, and OSHA log completion. Improved functionality is a major component of modern digital distribution efforts, including data and analytics capabilities like application pre-fill. Other digital priorities include quoting/submission functionality; support for online payment, reporting, and audit; and online sales.
Billing
Improved billing platforms offer carriers more efficient processing while offering agents and policyholders extended billing functionality. Some insurers are looking into capabilities like IVR or integrations with payroll solutions to ensure an automated feed accurate payroll information.
Data and analytics are another area of heavy investment; predictive analytics are being used for billing and utilization review, which was previously reserved for medical experts, nurses, or a third party. Workers’ comp carriers who provide other products can use new billing systems to consolidate requests for payment, customize payment schedules, and recalculate bills automatically.
Claims
Updated claims solutions are helping workers’ comp carriers stay competitive. The complexity caused by multiple jurisdictions with mandated benefits, long-term recurring payments, and continuing litigation can make things difficult. But disability management, medical case management, and return-to-work programs all contribute to carriers’ profitability.
Digital claims capabilities are increasingly allowing for collaboration with vendors, nurse case managers, and physicians. On the patient side, prepaid cards and other new payment options for injured employees are simplifying payment while reducing costs for insurers. Carriers are also using data and analytics to achieve a range of goals, including reducing costs and speeding up the claims process.
To learn more about the trends and technology impacting this space and to read examples of recent investments made by insurers, read Novarica’s latest report, Business and Technology Trends: Workers’ Compensation.
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