June 10, 2015
Created Tool that Alerts Adjusters of Claims Most Likely to Benefit from Nurses
A study from Liberty Mutual Insurance and Helmsman Management Services - the insurer’s wholly-owned third party administrator - helps brokers and buyers better manage workers compensation claim costs by quantifying the impact nurses have on such cases.
Based on the study’s findings, Liberty Mutual and Helmsman developed a tool that automatically notifies claim adjusters of those cases that would most benefit from a nurse’s involvement.
“We knew nurses had a positive impact on most claims, but wanted to identify those cases where nurses added the greatest value to injured workers and their employers,” says Glenn Shapiro, chief claims officer, Commercial Insurance. “By understanding the return nurses provide on compensation claims, we were able to develop a tool that reviews more than 20 key variables – from the part of the body that was injured, to the presence of co-morbid medical conditions – and alerts adjusters of those claims where nurses will have the most impact.”
The study is based on medical billing and claims data from 42,000 workers compensation cases. The data was sorted to develop two study groups for side-by-side comparison, factoring such issues as a claimant’s injury severity, behavioral or psychosocial characteristics, and attitudes toward work and rehabilitation. This enabled a comparison of the cost of claims that included a nurse to similar cases that did not involve a nurse.
The results answer the claim profession’s long-standing question about how much impact nurses have on workers compensation claims. In fact, those claims that involved a nurse had:
“However, adding true value to injured workers and employers requires focusing nurses on the right claims, rather than all cases,” explains Shapiro. “Quality trumps quantity. Adding a nurse to some claims would not have a significant impact on outcomes, and would just increase overall claim cost.”
More information on the survey - together with information on a range of other topics that add value to workers compensation buyers, brokers and agents - can be found at the Helmsman website.
About Liberty Mutual Insurance
Liberty Mutual Insurance helps people preserve and protect what they earn, build, own and cherish. Keeping this promise means we are there when our policyholders throughout the world need us most.
In business since 1912, and headquartered in Boston, Mass., today Liberty Mutual is a diversified insurer with operations in 30 countries and economies around the world. The company is the third largest property and casualty insurer in the U.S. based on 2013 direct premium written as reported by the National Association of Insurance Commissioners. Liberty Mutual is ranked 78th on the Fortune 100 list of largest corporations in the U.S. based on 2014 revenue. As of December 31, 2014, the company had $124.3 billion in consolidated assets, $104.0 billion in consolidated liabilities, and $39.6 billion in annual consolidated revenue.
Liberty employs more than 50,000 people in approximately 900 offices throughout the world, and we offer a wide range of insurance products and services, including personal automobile, homeowners, accident & health, commercial automobile, general liability, property, surety, workers compensation, group disability, group life, specialty lines, reinsurance, individual life and annuity products.