Category: Uncategorized

In our last newsletter, we described how Extended Duration Claims follow the 80-20 rule; 80% of the claim reserves are stable with predictable results, and the other 20% of reserves are where opportunity lies. The problem is finding a way to identify the 20%. If you have a large number of claims in this category, it […]

White, middle class adults are killing themselves deliberately and inadvertently, quickly and slowly. How bad is a life without work? I have been asked this question a lot lately. It is becoming pretty clear that the forces of globalisation and technological progress are reshaping economies and societies, especially in advanced economies, and that these effects […]

I’m a geek. I like numbers, models, and the big picture. Like a moth to a flame, I find big data both enticing and terrifying. When it comes to outlining clinical best practices, I want to understand the available evidence. But really, why would a disability and workers compensation medical director care about predictive modeling? […]

As I go around the industry, meeting many talented and experienced people who are involved in managing disability claims operations discussing the introduction of claim segmentation, the biggest issue is the ‘change’ in the process. How to do this without causing an issue? The rational for claim segmentation is clear, as soon as we suspect that an STD […]

The Mental Health Cognitive Kitchen – Recipes for a better understanding of Mental Health conditions. The Ingredients of the Diagnosis How do we determine if someone has a medical condition?  We use tests such as MRIs and X-rays. From those tests medical conditions can be discerned and then treated appropriately. With a mental health condition there […]

Does your claims process have a fast lane? Claim segmentation is a vital part of a more effective STD process, with less complex claims put through a ‘Fast Lane’ leaving claim managers more time to spend on complex claims. We have a fast lane for highways, Disney World, people with 10 items or fewer at […]

The Claim Lab is developing specialized models to predict return to work (RTW) for a range of conditions. Whilst doing our research we’ve referenced some previous studies, one we found particularly interesting was published in Neuropsychiatric Disease and Treatment, ‘Let’s get back to work: survival analysis on the return-to-work after depression’.[1] Aim The aim of this […]

There is a big opportunity in many claims operations to improve efficiency with greater automation of claims decisions. Every STD claim is still most likely touched by a claim manager, this isn’t an efficient approach, and there is a better way! Let’s ask some basic questions: What proportion of your STD claims are maternity claims? […]

Work-Focused Psychotherapy Helps Employees Return To Work Sooner Research published online in APA’s Journal of Occupational Health Psychology has found that employees who received work-focused therapy, returned to work sooner, did not suffer adverse effects and showed significant improvement in mental health over the course of one year. It turns out that maintaining a strong […]

As you are likely aware the Claim Lab is refining its models that predict the duration of return to work. Throughout this process we have been examining the research to help us identify the indicators needed for the model to be most effective. One such study that has proven particularly interesting was ‘Predicting Return to […]