In the world of risk management, claims are constant. For large organizations, they come storming in over the transom like snow flurries. Making sense of each one for risk mitigation purposes takes 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 quickly access an enormous amount of claims data from across the world to scrutinize workers compensation exposure trends, sifting through a mountain of data to discern and analyze loss patterns that guide insightful mitigation strategies.

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

When leveraged using a business app as opposed to a website portal, cloud-based claims management and analytics gives risk managers instant access to emerging loss trends on their tablets and smartphones. The possibilities for enhancements in worker safety are tantalizing, as are the consequent reductions in workers compensation exposures and related costs for employers, in addition to more targeted return-to-work programs.

Yet the insurance industry still has a ways to go to deliver on this promise, according to Costonis. “We are on our way, but not fully there,” he said.

The Next Iteration

Indeed, many insurance carriers, TPAs (third party administrators), claims adjusters, risk managers, medical care professionals, state claims bureaus and others involved in the vast workers compensation network continue to interact through hidebound communications systems. Even the mobile apps popping up are essentially an extension of current platforms, which are largely portal-based.

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

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

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

The confluence of these technologies is a boon for all involved parties. “The TPA , for instance, files a report to send for handling by the carrier the minute the risk manager receives an alert indicating the loss engineer has analyzed the situation and recommends these corrective actions in future,” Picone said. “In this scenario, we've successfully linked the safety process with the claims process. You can drill into the data to learn that there were 82 carpal tunnel claims in Denver last year, which compels you to figure out the causal factors and put in place mitigating strategies.”

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

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

Tomorrow Today

Mobile claims apps in the cloud will soon be ubiquitous, added Paul Braun, managing director, casualty claims at insurance broker Aon Risk Solutions. “This all started with the TPAs using tablets and smartphones to interact with adjusters, but it now is such a compelling value proposition that all others in the [claims] process need to interact the same way. That day will come soon,” he said.

Aon Risk Solutions has created a mobile app linked to a claims data warehouse in the cloud (RIScloud), which is a significant step up from its prior claims management tools. “The problem with using portals to access this information in the past was that it restricted you from moving large components of data quickly,” Braun said. “The cloud takes care of this, and the mobile component offers access anywhere at any time.”

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

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

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