Predictive Analytics Help Wayward Workers’ Comp Claims

By Denise Johnson | June 3, 2016

  • June 9, 2016 at 8:18 pm
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    I wholeheartedly agree that predictive analytics will help identify potentially complex, expensive, and even questionable claims. To manage it [disability],we must first measure it. Yes, the claims adjuster can then dedicate more focused efforts on the outlier cases, but ultimately subject matter expertise/SME[e.g. clinical]is required to provide professional opinions which are within reasonable medical certainty and, compare/contrast case merits with community standards of care. Even then, “evidence-based practice” often has thin evidence, which further supports the value of SME.

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