Insurers' claims management efforts are working, but there still is room for improvement.
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The results show that companies perform very differently when it comes to dealing with claims, especially when dealing with back strains and sprains. The survey found that there is a 22% difference in the expected recovery rates between the best and worst performers. This reflects on the claim management practices employed, which vary widely from carrier to carrier, Claim Analytics says.
The challenge with musculoskeletal claims (back sprains and other soft tissue injuries), according to the study, is that there is little physical evidence to verify the severity of the injury. There also is risk of pain killer addiction, and the possibility of surgeries, which carry a higher risk of abuse or fraud.
The 12 insurers that participated in the study were:
- Aetna Life
- Guardian Life
- ING Employee Benefits
- Met Life
- Principal Financial
- Sun Life Assurance Co
- Assurant Employee Benefits
- Hartford Life
- Lincoln Financial
- Mutual of Omaha
- Prudential
- Unum
“This is the second year of carrying out this study, and it really represents the coming of age of our predictive modeling techniques," says Barry Senensky, Claim Analytics president. "This year we had more of the leading insurance companies participate, which is a testament to the validity of our work and the importance of these findings”.
The results were presented anonymously. While each company knew how they performed in the comparison, they could not identify to which contributor the other results belonged.
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