Does This Study Prove Overworked Claims Adjusters Exist?
Is this a sign of overworked claims adjusters, or did I incorrectly interpret one of the main points in the Rising Medical Solutions 2024 Annual Benchmarking study? Let’s examine this question from two angles.
The annual 2024 Rising Medical Solutions study series has cranked out studies for over a decade. Go here to obtain a copy of the study report. Rising will not hit your email inbox with a ton of spammy emails.
I viewed the webinar presentation on August 6th, which you can view on demand here after registration. The webinar was sponsored by Risk & Insurance (The Institutes).
Many articles appear in this blog that cover the Benchmarking studies over the years. Two points that stood out during the webinar are covered below.
Proving My Premise
Adjusters are now required to use more separate systems to do their jobs. One huge point was that the claims systems were built and then required the personnel to adapt. The old “build it and they will come” adage fits well here.
A longtime industry friend of mine, Denise Algire, Director of Health, Albertsons Companies // WC Benchmarking Study Author, said in her closing remarks to keep the users in mind when AI systems are created for claim departments. (paraphrased comment)
Looking at page 13 of the benchmarking report, with a systems engineer background, this chart taken from the study report shows that the newly created AI systems now require already overworked claims adjusters to access more systems; some of the companies had more than seven systems. What? Check out the chart below.. Yes, and Google loves chart pics.
One can easily see that the number of systems that claim departments have to use has increased from 42% to 55% in a few years. Already overworked adjusters have seven systems to use in 18% of the claims department. Wow!
Overworked Claims Adjusters Used to Not Being Focus
One of the themes that appears on this website stems from asking the claims adjusters for their opinions before creating an AI or IT system. Many studies have been done that covered claims departments, but no one thought to ask the people in the trenches.
The second point that stood out to me in the presentation and report was Denise’s comment, and this quote from Harvard Business Review that appeared in the study.
“The most compelling digital experiences start with a meaningful understanding of the customer – unfortunately, many organizations have it backwards, they start with the technology and then back into customer understanding”
The overworked workers’ comp claims adjuster remains a going concern for the forward-thinking claims departments.
