A claim review is an important step in an organization’s claims management process. Typically involving formalized, interactive discussions among the client, the carrier or third-party administrator (TPA), and their broker’s claim advocate, these strategy sessions aim to uncover actionable trends, targeting areas with the greatest potential impact on claim outcomes and costs.
For a claim review to be most impactful, selecting the right files to review is imperative. For smaller organizations with few claims, it may be appropriate to review the majority of their open inventory. However, for larger enterprises, the effectiveness of the claim review can depend on being able to recognize which claims are most likely to become high exposure claims. As such, it is critical to work with a team that has the predictive analytical tools and skillset necessary to determine which files to review and discuss.
Part of Blue[i] Analytics — our next-generation analytics suite of solutions — Marsh’s enhanced claim review process increases client value by integrating our deep claim expertise with insights from our comprehensive claims data. This digital process enables our claim advocates to lead with analytics, giving us the ability to help clients better identify areas of opportunity, which in turn can help drive down the costs of our clients’ worker compensation claims.
Throughout this process, Marsh claim advocates closely monitor carrier and TPA outputs, and work to understand client expectations. Our claim advocates offer insights and recommendations that help improve claim results. We assist clients in assessing claim file reserves set by their claims administrator and in developing resolution plans to help drive down their total cost of risk.
Marsh’s claim review process typically starts with a planning session with the client. Our file selection process leverages industry leading artificial intelligence (AI) capabilities to run data through algorithms to help identify the most complex claims, early in their lifecycle.
During the claim review meeting, we utilize our enhanced claim review questionnaire to gather relevant information from the client and the carrier or TPA.
At the conclusion of the claim review, we generate a recap of agreed to actions items and notes with the push of a button. The final output of the process is our new dynamic executive summary dashboard. This dashboard offers both micro- and macro-level reporting capabilities, allowing for data-driven gainful insights.
Our digital process facilitates efficient and timely closing of outstanding claims, with the ultimate goal of achieving positive claim outcomes for our clients while assisting their employees in their recovery from work-related injuries.
At Marsh, we understand that your employees are your most valuable asset and recognize your desire to protect and promote their health and safety. From insurance advice and placement to pre- and post-loss advisory solutions, our specialists can support your efforts to reduce workers’ compensation loss costs, improve productivity and profitability, reinforce behaviors in support of key business objectives, and develop and implement sustainable safety programs.
Director of Workers’ Compensation Claims, Marsh’s Workers’ Compensation Center of Excellence
United States
Dennis Tierney is the director of claims within Marsh’s Workers’ Compensation Center of Excellence. He is responsible for establishing continuing processes and protocols around the delivery of advocacy services related to workers’ compensation.
