As the continued rise of data-driven technology (cloud, advanced analytics, and microservices-based APIs) is enabling Group Disability Insurance carriers to unlock intelligence buried in their systems and forms and convert it into valuable customer insight, it is also creating new opportunities for Group Disability Insurance carriers to differentiate themselves. Combined with evolving customer expectations, data-driven technology is allowing them to partner with employers to create a healthier, more productive workforce and advise on leading practices to prevent disabilities and accelerate the return to work.
Imagine that the primary interactions that carriers will have with clients consist of leading practice discussions on workplace accommodations and return-to-work interventions, rather than today’s typical focus on issue management and bill reconciliation. A recent McKinsey report noted that in the next 10 years, claims processing will be automated through AI and AI-enabled, machine learning–based modelsi. Claims processing will remain a primary function, but carriers will increase their focus on risk monitoring, prevention, and mitigationii. This would be a major shift in the industry and also allow carriers to showcase the other value-adding qualities of their businesses to clients.
However, unlocking data and putting data-driven information to work for carriers’ clients requires core technology investments. Carriers require a modern claims platform that offers a single source of truth, with rules-based capabilities to facilitate intelligent case segmentation and routing as the foundation. Native cloud platforms ease the aggregation of data from multiple sources to support 360-degree analytics. API-first enabled architecture facilitates real-time integration with core systems and external ecosystems such as niche data providers in behavioral health, musculoskeletal, or other high-propensity medical conditions for creating more relevant and meaningful insight.
These resulting, powerful, data-driven insights could enable claims specialists to engage with claimants to advise on best practice interventions to mitigate having certain conditions become chronic and ultimately disabling. Complex cases could be more quickly routed to specialists based on historical results of eligibility decisions or return-to-work program recommendations. Account managers could also advise plan sponsors on leading practices in return-to-work accommodations for specific industries, geographies, or job roles.
To further evolve with this industry shift, carriers must also implement changes to the operating model for the roles and skills within the claims operation in terms of data fluency, communications, and relationship management skills. AI and data modeling instruction will be of particular use to employees who move to risk monitoring and mitigation advisory roles from claims-processing functions.
Insurance has always been a data-intensive business. Carriers that unlock that data, harness its insights, and become trusted advisors on risk mitigation as well as claims processing to their customers will be able to differentiate themselves from other industry players for years to come.
ihttps://www.mckinsey.com/industries/financial-services/our-insights/insurance-2030-the-impact-of-ai-on-the-future-of-insurance.
iiIbid.
