The Use of AI in Workers Compensation Legacy Transaction with Rooney Gleason

AIRROC Spring 24 Member Meeting: Educational Session

Last week, Rooney Gleason, EvolutionIQ’s Chief Insurance Officer, held an educational session at the AIRROC Spring 2024 Member Meeting focusing on the financial dynamics of utilizing AI in legacy transactions. Discussions ranged from the ways in which AI is enhancing insurers’ ability to provide prompt service to claimants, how AI is empowering claims professionals to make swifter and more informed decisions, and how AI is facilitating the adoption of innovative claims management strategies. EvolutionIQ highlighted how customers are mitigating losses, reducing claims costs, and empowering senior leaders to reinvest capital back into their businesses.

Here are some key points from the session:

  • Carriers are discovering they can unlock capital hidden in traditional claims handling processes and are now able to efficiently sell liabilities to multiple carriers. On the seller’s side, there is a high degree of competition, as sellers are looking to settle claims for the lowest price possible.
  • The benefit of EvolutionIQ’s Claims Guidance platform is the oversight management of claims. The software identifies claims that are resolution ready faster than a human could identify them.
  • Regulation of AI is a recurring theme right now, specifically with the National Association of Insurance Commissioners. Insurance commissioners are collaborating to establish guidelines for effectively supervising AI usage. New York, Connecticut, California, and Colorado are among the states closely monitoring the evolution of this technology.
  • With innovative insurers already deploying the technology in the market, there’s a risk that late adopters may fall behind. Panelists emphasized that carriers trailing industry leaders by 12 months could soon find themselves needing 3-5 years to catch up, given the rapid pace of technology adoption.
  • Daily prioritization, a feature of the EvolutionIQ, platform functions by updating data every night from claims and carrier organizations in order to reprioritize each claim in the block. The software identifies the specific areas adjusters servicing the claims need to address.
  • Our goal [at EvolutionIQ] is that we want adjusters to make an impact daily, advancing towards resolution with each action. We’re monitoring every claim to closure.
  • As for the future of AI in legacy business, until the laws change, you’re going to need an adjuster. Panelists concurred that entrusting decision-making to claims experts is crucial, emphasizing a future characterized by collaboration between humans and AI to foster more meaningful connections and interactions. EvolutionIQ further emphasized that their platform is tailored to empower claims professionals throughout the organization, enhancing planning, forecasting, claimant support, and claims resolution processes. Currently, there are no laws permitting machines to approve claims. Most laws mandate that the adjuster must approve claims involving injured workers.

Panelists:

  • Rooney Gleason, Chief Insurance Officer at EvolutionIQ
  • Travis Grulkowski, Principal & Consulting Actuary at Milliman
  • Justin Herring, Partner at Mayer Brown
  • Michael Terelmes, Compre Group
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