How workers' comp insurer uses automation to enhance client services

Robust solutions are needed in the pandemic era

How workers' comp insurer uses automation to enhance client services

Workers Comp

By Bethan Moorcraft

Workers’ compensation insurer Service Lloyds Insurance Company announced in October 2021 that it had selected Origami Risk’s property/casualty insurance solution claims suite to implement a fully integrated, single platform for claims adjudication, reporting, and delivery of enhanced client services.

The claims suite gives Service Lloyds a variety of tools and functionality to manage claims more efficiently and provide more robust services to agents, brokers and insureds. These tools include: easy-to-use dashboards that display complete and real-time information on the status of individual claims; a mobile app to give claimants easy access to timely information; real-time connection with Service Lloyds’ EDI partner to ensure accurate submissions; and portals for agents and insureds to access claim information.

In recent years, Service Lloyds has expanded its operations across the United States. In tandem, the workers’ compensation insurer has invested in technology and automation to gain efficiencies and enhance customer service.

Regarding the partnership with Origami, Meghan Welte (pictured), claims supervisor at Service Lloyds, said: “We went through an extensive vetting process with multiple vendors, using the same matrix to ensure nothing was overlooked. Not only did Origami fulfill everything we were looking for, but they also provided a system that could easily grow with us. With this growth and ongoing partnership with Origami, we are allowed to be more competitive not only as an insurer, but as an employer as well.”

Jacob Clymer, COO at Service Lloyds, said: “Origami is proving to be a valued partner by delivering and quickly implementing a full range of robust solutions that are difference makers not only for our internal claims teams, but also for agents, brokers, insureds, and injured workers.”

Speed and efficiency are what all stakeholders in the workers’ compensation chain are looking for. As Welte pointed out, employers today want to ensure that their employers are taken care of after an injury, and having access to real-time information can help to relieve some of their concerns.

“They want to be able to log in, see what the claim status is, and how the injured worker is doing, without having to make a phone call or send an email,” she said. “With Origami, they are allowed to do just that, and because of the security provided, we can rest easy, knowing they are able to see only the information they are entitled to, but not the employee’s protected medical information.

“The injured worker is also able to get claim specific information via the mobile application, giving them time to focus on healing with less worry about contacting the claims office directly. This is also a benefit to the employers as it makes the entire claim process that much easier.”

Technology and increased automation have proven beneficial for workers’ compensation insurers during the COVID-19 pandemic. However, there was a relatively steep learning curve, particularly in the first year of the pandemic, for both patients and providers in learning how to utilize and maximize upon the available technologies.

“COVID-19 has made claims handling much more complicated. We went from the 2019 way of in-person office visits, case managers meeting directly with injured workers, and claims personnel meeting with employers to the new normal of social distancing, telemedicine, and Zoom everything,” she told Insurance Business. “Employees had, and still do in some areas, longer healing times due to delays in “elective surgeries”, and a reduction in appointment availability, added to a technological learning curve for both patients and providers.

“The dispute resolution process has also been a challenge in the pandemic as required appointments were no longer being set and hearings were delayed causing an overall delay in resolution. This led to additional treatment delays [and] in some cases, treatment would not be rendered until the dispute was resolved.”

As Service Lloyds has expanded during the pandemic, the insurer has prioritized the automation of various elements in its claims administration process, Clymer explained, with a primary goal of “enhancing service and overall increasing the client experience.”

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