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Claims Triage Beyond the Usual Suspects

As insurers become more familiar with the power of analytics technologies, they continue to look for new opportunities to further leverage capabilities, making claims triage a logical next step.

By Jim Haley | Updated on December 27, 2010

Claim triage is hardly a new concept. Every insurer looks to achieve early identification of those workers’ comp claims that run the risk of high medical costs and a long payout period. Early intervention into those cases could give insurers more control over the handling of the claim, the medical treatment, and the overall costs with an earlier return-to-work.

Serious injuries that result in the loss of a limb or severe burns are obvious candidates for claim triaging, but, what about those developmental claims that are not as obvious? On the surface, developmental claims may appear trivial, and may not raise any red flags. As time goes on, however, these claims start to show their true colors in the form of exorbitant managed care costs and out of control medical expenses.

 

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