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AI claims management can help reduce legal involvement in comp: Study

Posted On: Sep. 21, 2023 1:26 PM CST


Workers compensation claims management that utilizes artificial intelligence can help reduce the need for legal involvement in lost-time claims, according to findings from an AI software provider.

Gradient AI, a Boston-based company offering AI services for the insurance industry, said it analyzed more than 200,000 lost-time comp claims from more than 60 insurers during a 10-year period and found there to be a 15% reduction in legal involvement in lost-time claims using AI.

The study also showed a 5% reduction in lost-time claims costs, which researchers said can equate to $3.5 million annually.

The study attributes the savings to providing insurance adjusters with early alerts regarding injury severity and claims status changes.

The use of AI models enabled insurers to manage comp claims more efficiently and effectively, resulting in reduced legal involvement and cost savings, the study said.  

Researchers said AI helped reduce attorney involvement because models could assess claim complexities, predict the likelihood of legal involvement and provide early warnings to claims adjusters.