Tech Trend #34

Injury Claims: P&C’s Predictive Advantage

Laura Drabik

Chief Evangelist

Guidewire

LAURA (ONSCREEN AND VO)

With rising injuries, medical inflation, and litigation risks, global injury claims costs could exceed $800 billion this year.

As a result, carriers increasingly turn to predictive analytics to shift from reactive to predictive claims handling—accelerating recovery while controlling costs.

Today, bodily injuries are the biggest driver of rising premiums worldwide.

Bodily injuries represent about 50% of US auto claims costs, with severity up 20% in three years. Australia’s bodily injury claim sizes are increasing 5.5% annually since 2013. Similar trends are evident in the UK and Canada.

Workplace injuries are also rising, driven by aging workforces and increasing mental health issues.

Medical costs for treatments and prescriptions outpace consumer inflation, intensifying insurer pressures globally.

Here in Australia, psychological claims rose 47.5% over four years, with workplace injuries and illnesses costing employers around $30 billion annually.

Predictive analytics are crucial for quickly assessing severity, assigning claims efficiently, and accelerating personalized treatment.

Carriers with modern insurance platforms have a clear advantage.

Using Guidewire as an example, the Claims Intel solution in ClaimCenter applies predictive analytics from diverse data sources. It scores severity, loss estimates, attorney involvement, and litigation risks.

For example, in road accidents, the system quickly flags high whiplash risk based on impact data, claimant’s age, and medical history. This accelerates assignment to specialized adjusters, reducing cycle times and costs.

In workers’ compensation, the system recommends optimal modified duty plans based on historical claims data, helping adjusters improve outcomes and loss ratios by approximately 52 basis points.

When integrated with Guidewire, third party AI solutions like those from CLARA Analytics, EvolutionIQ, and other Guidewire partners further streamline processes, cut medical costs by an average of 15%, and minimize litigation risks.

These and other predictive analytics-driven insights feed into Guidewire’s Autopilot Workflow Services, helping adjusters and case managers prioritize critical tasks requiring judgment and empathy.

BRAD LONTZ/COPPERPOINT CLIP:

“Equipping [the most appropriate claims adjuster] with insights has a big impact on return to work.”

LAURA (ONSCREEN AND VO)

Whether it’s a road collision in Bondi Beach, or workplace accident near Melbourne or anywhere else worldwide predictive analytics is transforming claims management from reactive to predictive—driving cost efficiency and optimizing claims outcomes.