In the world of risk management, claims are constant. For largeorganizations, they come storming in over the transom like snowflurries. Making sense of each one for risk mitigation purposestakes extraordinary time and effort.

Now imagine the computing power of cloud-based claims systems.Such hosted platforms have the horsepower to provide great reach,easy deployment and wide flexibility. A risk manager can quicklyaccess an enormous amount of claims data from across the world toscrutinize workers compensation exposure trends, sifting through amountain of data to discern and analyze loss patterns that guideinsightful mitigation strategies.

How insightful? “You have the ability to take a subset of theold-fashioned loss run and match it together with a data source yousee in the cloud, and then run the analytics to immediately learn,for instance, that a particular problem exposure happens on thethird shift of every Thursday when production levels are higher,”said Michael Costonis, managing director, global claims businessservices, at consultancy Accenture. “You can then tweak yourprocedures to alleviate this problem.”

When leveraged using a business app as opposed to a websiteportal, cloud-based claims management and analytics gives riskmanagers instant access to emerging loss trends on their tabletsand smartphones. The possibilities for enhancements in workersafety are tantalizing, as are the consequent reductions in workerscompensation exposures and related costs for employers, in additionto more targeted return-to-work programs.

Yet the insurance industry still has a ways to go to deliver onthis promise, according to Costonis. “We are on our way, but notfully there,” he said.

The Next Iteration

Indeed, many insurance carriers, TPAs (third partyadministrators), claims adjusters, risk managers, medical careprofessionals, state claims bureaus and others involved in the vastworkers compensation network continue to interact through hideboundcommunications systems. Even the mobile apps popping up areessentially an extension of current platforms, which are largelyportal-based.

“Things like loss reporting, claims analysis and the downloadingof loss-related data—all basic stuff really—is for the most partbeing pushed onto a mobile device, which is still useful,” saidCostonis. “But, it scratches the surface of what is possible.”

Claims information typically is downloaded to Excel spreadsheetsfor analysis, but is not quite the “self-service mobile claims app”the industry can avail, Costonis said. “We've not yet embraced whatit means to have this core transactional data in the cloud andavailable 24/7 in a highly flexible and scalable architecture. But,from my discussions with brokers and carriers alike, this is on theroadmap. We will soon see far more precision in the overall claimsprocess, directing significant improvements in the management ofthe underlying risks,” he said.

Others share this view. While mobile claims management in thecloud via a business app is available from insurance broker Willis,Joe Picone, chief claim officer in the New York office said thatbroad usage “is still at the infancy stage.” Nevertheless, he citesthe significant opportunities at hand. “The cost of the cloud ischeap and it's dependable—the downtime is minimal in that you canswitch servers fast in a catastrophe. And mobile apps are extremelyconvenient. Your safety people can be doing an accidentinvestigation at the same time that they're filling out the claimsdata,” he said.

The confluence of these technologies is a boon for all involvedparties. “The TPA , for instance, files a report to send forhandling by the carrier the minute the risk manager receives analert indicating the loss engineer has analyzed the situation andrecommends these corrective actions in future,” Picone said. “Inthis scenario, we've successfully linked the safety process withthe claims process. You can drill into the data to learn that therewere 82 carpal tunnel claims in Denver last year, which compels youto figure out the causal factors and put in place mitigatingstrategies.”

Willis offers its corporate clients access to its RiskonnectDatawize mobile app, a claims management system availablepreviously only through a website portal. The app features adashboard with easy to follow directions on inputting and receivingclaims-related data. Where it fall shorts is its disconnection fromother parties in the workers compensation space, such as doctors,nurses and case managers, according to Picone. “Definitely this iswhere we are headed. We are pushing towards a fully integrated,all-encompassing app. But, we think what we already have is prettymuch state-of-the-art.”

Even in its current iteration, the app presents the possibilityto shave weeks off the return-to-work process, assuming theinvolved parties use the tools. “A nurse case manager at thedoctor's office can pull up the injured worker's job description onher tablet, and have the doctor sign off on the match between theinjury and the job performed by the employee,” Picone said. “Thequicker data is turned into information for decision-makingpurposes, the faster people are back on the job.”

Tomorrow Today

Mobile claims apps in the cloud will soon be ubiquitous, addedPaul Braun, managing director, casualty claims at insurance brokerAon Risk Solutions. “This all started with the TPAs using tabletsand smartphones to interact with adjusters, but it now is such acompelling value proposition that all others in the [claims]process need to interact the same way. That day will come soon,” hesaid.

Aon Risk Solutions has created a mobile app linked to a claimsdata warehouse in the cloud (RIScloud), which is a significant stepup from its prior claims management tools. “The problem with usingportals to access this information in the past was that itrestricted you from moving large components of data quickly,” Braunsaid. “The cloud takes care of this, and the mobile componentoffers access anywhere at any time.”

With regard to the value of the tool, he cites the example of alarge retail store chain. “Say a couple stores experience a highvolume of workers compensation claims for a particular position.The risk manager gets to the bottom of the causes and posts thisinsight. Other stores now can access the data warehouse to look atthis data and learn from it,” Braun said.

Like the other claims experts, he agrees the promise of mobileclaims management is ahead of its full realization. “This has yetto become as simple or easy as downloading music on an iPhone, butthat day is coming soon,” he said.