This year, like many recent years, has brought emerging uses of technology to the forefront of many industry-wide conversations. Overall, technology continues to improve and oftentimes can enhance efficiency within many fields, including the automobile no-fault and workers’ compensation insurance industries.
For instance, artificial intelligence (often referred to simply as AI), is perhaps one of the most talked about technologies of today. Various AI models are within use throughout the work comp and auto no-fault claims processing fields. Some insurance companies may use AI as an assistant of sorts when it comes to administrative tasks. Other companies may deploy AI to analyze claims and flag suspected cases of fraud for further review by an adjuster or an examiner.
While AI and other new or developing technologies can certainly appear to come with many benefits, caution must be used. Caution when utilizing AI within the claims adjudication space is especially critical, as any mistakes made here could have negative consequences for your company as well as your claimants.
It is also crucial that your company develop regulations and policies around how AI will be used within claims, if you choose to use AI at all. For instance, leveraging AI to flag suspicious claims could be a helpful tool for your examiners and adjusters. However, AI cannot be relied upon to be entirely accurate at this point, so your AI policies must also address how an experienced team member will determine what is and isn’t fraud based on AI’s flags.
Without the addition of someone reviewing those potential flags, AI could very well deem a legitimate claim as suspicious or fraudulent, leading your team members to close the claim without indemnifying your claimant. This of course would be detrimental to your claimant and potentially carry negative consequences for your insurance company.
Other forms of technology can certainly play a role in streamlining the claims process and relieving your examiners and adjusters of some administrative burdens. On the other hand, an overreliance on AI or other emerging technology can carry negative consequences for all parties involved in a claim. This highlights how critical it is to partner with an experienced durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS), pharmacy and ancillary service provider that leverages technology wisely.
Northwood has over 30 years of experience administering auto no-fault and work comp claims. While Northwood fully embraces the benefits of technology, caution is also used. Furthermore, Northwood prioritizes a humanized approach which boosts claimant satisfaction as well as your company’s bottom line. For a more thorough review of how Northwood would utilize technology while prioritizing quality care and an excellent claimant experience, please call Rosanne Brugnoni at 586-755-3830 ext. 3771.
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