Case Study

The Hartford has a large workers’ compensation business, ranked 2nd in the nation based on direct written premiums. Workers’ compensation is insurance that provides coverage in the form of cash payments or medical care for workers who are injured on the job. Recently, the company discovered that a significant proportion of claims that were made through the workers’ compensation department were relatively simple claims, referred to as “medical only,” that required only coverage for medications or medical care and not more complex areas such as lost wages or time off work. Medical-only also includes claims that do not require any significant medical intervention or service, as well as claims where the treatment was completed before the claim was filed. This area represented a prime opportunity for automation, where work previously done by a claim administrator would instead be automated using custom-built computer algorithms, freeing up staff members to do more complex work. They determined that some medical-only claims processes could be automated, eliminating multiple human touchpoints without sacrificing compliance or customer outcomes. As with other automation efforts, AI often creates significant financial returns and efficiency gains, giving work previously done by humans to a machine. Unlike many automation efforts, though, The Hartford did not find savings through eliminating workforce. Rather, they took the opportunity created by the automation and reformed roles to fill different business needs, enabling the entire workers’ compensation department to handle more, more efficiently.