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Workers' comp claims leaders lift closure ratios through better execution
Rising Medical Solutions found the share of claims organizations reporting closure ratios of 101% or better rose to 36% from 30% in its prior study.
Rising Medical Solutions’ latest benchmarking study on workers’ compensation says the top-performing claims organizations are not pursuing radically different strategies than peers, but are better at implementing what they approve. The study points to investments in artificial intelligence, automation, workflow redesign, and improved experiences for claims teams.
According to Risk & Insurance, the key differentiator is what happens after plans are approved, with higher performers showing stronger claims outcomes. The share of organizations reporting claims closure ratios of 101% or better increased to 36%, up from 30% in the previous study.
The report also notes that superior performance is not tied to having easier claims, as higher performers are more likely to hold heavier concentrations of active indemnity claims. It frames the main challenge as maintaining focus among competing priorities.
Risk & Insurance adds that, speaking at the workers’ comp forum, Stacey Foote, vice president of claims at The MEMIC Group, said it is easy to encounter many vendors and suggested that the most important step is finding which specific problem to address.