Two of the major cost drivers for bodily injury claims are whether they are litigated and if the claimant requires surgery. Historically, determining whether a claimant is likely to have surgery or is going to litigate a claim occurs after the fact, when it is too late to mitigate the loss.
To help overcome this challenge, Zurich developed predictive models to help identify the likelihood that a claimant will have surgery or that a claim will be litigated. By having this information early in the claim handling process, the claim professional can take proactive steps to address the issues and manage the claim appropriately.
“We can’t predict the future, but with our analytical tools, we can obtain insights on whether certain events are likely to occur and better manage them,” said John Mahoney, senior vice president of Technical Claims for Zurich North America.
Zurich leveraged its significant modeling expertise to develop the Bodily Injury Liability Claims Models. Zurich relied on its extensive database of millions of historical data records and built the model by combining the loss information with other internal and external data sources. The model’s output is used in the assignment process to ensure that the claim is handled by a claim professional with the appropriate level of experience.
“We get the biggest impact when we identify and address those cost drivers early in the claim handling process aimed to generate the best outcome for our customers,” said Steve Hatch, chief claims officer for Zurich North America.
The Surgery and Litigation Models are the latest predictive models in a suite of analytical tools developed over the past few years to better manage claims.
Source: Zurich Insurance Group