Data-driven Approach for Psychosocial Claims Management Models ANZ

Workers’ compensation and social insurers in Australia are grappling with rising recovery durations and costs for serious injury claims.

While there are many drivers of this phenomenon, mental injury claims and claims with associated psychological distress are major factors. Research provides evidence that identification and treatment of the psychosocial aspects of a serious injury claim can have a significant impact on durations and costs.

These drivers of duration and cost, and the benefits of a biopsychosocial approach to treatment and recovery are well-known to workers’ compensation and social insurers. Many have programmes in place  to identify the risk profile of claims so they can act early and tailor a recovery journey. However, the approach to effectively manage the sheer complexity of interactions between an insurer and the broad range of stakeholders requires the collection, collation and analysis of immense pools of data. It is quite a formidable task.

The FINEOS Platform for Claims Management

Using the FINEOS Platform to manage claims allows insurers to optimize data assets to understand the attributes of a claim which signals the need for a more proactive approach. Hands-on case management is then allocated to determine personalized strategies focused on improving outcomes. The FINEOS Platform employs a number of purpose-built features to streamline and automate much of the disability claim lifecycle, freeing up case managers to concentrate time, energy, and expertise on high-value activities with the other stakeholders on the claim. This then provides the best opportunity to resolve workers’ compensation claims with shorter durations and lower costs.


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