9/9/2019

Emerging Developments in Claims Resolution

We ask CLM members and fellows what is helping them close claims faster and more accurately.

By Phil Gusman

Question: What is one emerging development in the claims and litigation landscape that you believe will be most helpful in resolving claims faster and more accurately?

“Telemedicine. And more so, effective utilization of telemedicine. In order for it to be effective in claims, it must provide injured workers immediate connection to a physician who has emergency-room or occupational-medicine experience, and offer an avenue of follow-up care. Tele-emergent care is treatment; not triage.”

Claire Muselman, Director of Workers Compensation, Continental Western Group. CLM Fellow since 2018.

“The impact of social media and a person’s ‘online footprint’ provides claims representatives and counsel with insightful tools to vigorously contest allegations of physical injury and/or limitations. To utilize a claimant’s own postings as ‘admissions’ to challenge their claims may increase the potential for early resolution at a better value for our clients.”

Andrew S. Kessler, Partner, Wood, Smith, Henning & Berman LLP. CLM Member since 2015.

“One often overlooked positive change to the claims and litigation landscape is the influx of millennials in the workforce. As a large percentage of insurance professionals retire, millennials offer ingenuity and technological discernment, which plays a key role in expediting problem solving and maximizing efficiency.”

Flavia Pemberton, Vice President, Environmental Claims, Ascot Group. CLM Fellow since 2008.

“The broad expansion and availability of technology has made a difference not only in how quickly information can be transferred from one party to another, but also how accurate that information is. Our ability to handle claims in compliance, and to preserve documentation from anywhere to the loss location, has made the process more efficient and accessible.”

Mary Anne Medina, Vice President of Marketing, Specialty Group Inc. CLM Fellow since 2010.

50%

Percent of the U.S. workforce expected to be made up of the millennial generation by 2021.

Source: Akumina

76%

Percent of hospitals fully or partially implementing computerized telehealth systems, compared to 35 percent in 2010.

Source: American Hospital Association

69%

Percent of U.S. adults who say they use Facebook.

Source: Pew Research Center

$1.7 Billion

Amount of insurance tech funding in 2016, up from $223 million in 2010, but down from $2.65 billion in 2015.

Source: CB Insights

51%

Percent of millennials who say they are actively looking for a different job as they seek greater work-life balance and personal wellbeing.

Source: Gallup

 



Phil Gusman is managing editor of CLM magazine, a publication of the CLM. He can be reached at phil.gusman@theclm.org.

Top Industry News

Powered by : Claimspages


AM Best