Car insurance companies have been collecting data derived from telematics, apps for smartphones and video to predict the severity of injuries sustained in crashes. The same injury prediction technology may be applied to workers’ compensation claims in the future.
Artificial intelligence (AI) predicts the type of injuries a claimant may have sustained in a crash, and the potential severity of those injuries, using collision data collected from different sources. Carriers can use that information to triage the claim to the right adjuster.
Adjusters could avoid a spiraling claim by fast-tracking a settlement when the model predicts mild injuries. By contrast, the claim can be managed more efficiently moving forward by better understanding the predicted treatment timeline when more severe injuries are predicted by the model. The AI predicting these injuries can also assist adjusters in determining if treatments submitted for reimbursement in a claim are truly the result of the injuries from the accident.
This use of AI to predict injury severity and type in the auto insurance business could potentially be applied by workers’ comp organizations to quickly get claims to the right teams, identify fraud, process claims more quickly, and improve workplace safety.
Last year, more than a million workers’ compensation claims were auto-coded by researchers using AI. The result is a new resource of injury intelligence that insurers, brokers and employers can use to better understand injury trends and to potentially avoid common work-related injuries in the future. The study, which was conducted by the National Institute for Occupational Health and Safety and the Ohio Bureau of Workers’ Compensation, used AI to determine the cause of 1.2 million claims and categorized them as ergonomic related; slips, trips and falls; or “other.” What took the computer program three hours to categorize would have taken a human 4.5 years.