Trends in Third Party Claims and How to Address Them

Tom Kerr (TK): Enlyte recently released our Annual Trends Report and to supplement that content, we asked Norman Tyrell from our Mitchell third party auto team to discuss major trends in third party claims and how they’re impacting our industry.

 

Norman, thanks for joining us.

Norman Tyrrell (NT): Thanks for having me.

TK: So let’s get started. What are the top trends you are seeing today impacting third party claims organizations and how have things shifted since the beginning of the pandemic?

NT: 影响第三方汽车索赔的主要趋势有两个, for that matter, the entire property and casualty industry as a whole. The first of these is the changing insurance workforce.

Remote Work

As we highlighted in our recent Annual Trends Report在美国，保险和许多其他领域都出现了向远程工作的巨大转变.

在2020年之前，只有不到10%的专业劳动力全部或大部分时间在家工作, 一些专家认为，在疫情高峰期，远程工作的比例超过70%, today, it seems to have normalized with approximately 60% of the professional workforce now working primarily from home.

不用说，这是理赔调整环境的重大转变. Many industry executives are dealing with how to ensure that the benefits of face-to-face collaboration in insurance office locations doesn’t disappear as the next generation of adjusters enter the workforce remotely.

Severity

我们看到的另一个大趋势是严重程度的增加，这当然不是新的. Since 2017, we have seen the average paid claim cost for third-party liability increase by 27% according to data from ISO Fast Track. 由于包括社会通货膨胀在内的许多因素，这些成本在过去几年中一直在上升, “nuclear” settlements and increasing medical costs.

We recently published an analysis of Mitchell’s third party medical bill review charge data for claims created in our bill review systems between 2017 through the end of 2021 to examine medical cost inflation trends across the country. 从2017年到2021年底，医生对第三方索赔的单位收费增长了9%. It is interesting to note that first party medical bill increases were only at about a 4% increase during that time. And for comparison, during the same time period, 美国劳工统计局医师服务消费价格指数上涨6%.

TK: 我们能不能更深入地研究一下医疗通胀是如何影响第三方成本的?

NT: Yes. 以帮助更好地了解一些具体的第三方医疗费用趋势, we also examined medical inflation by service group. Not surprisingly, 评估管理和疼痛管理服务的收费都有显著增加. 2017年至2021年间，评估和管理服务的单位收费增长了19%.And the charge per unit for pain management services increased 32%.

So, you can see that these increases are significant.

TK: Are there other service groups impacted by medical severity?

NT: Sure. Additionally, Mitchell’s medical bill review analysis also highlighted a few other service groups that are commonly associated with trends in medical severity:

It’s notable that while chiropractic therapy, emergency services, radiology and physical medicine experienced little change in the charge per claimant metric throughout the pandemic, 物理医学和脊椎按摩疗法实际上从2021年第三季度开始出现了增长, which amounted to a 33% and 21% increase.

And most significantly, 我们看到，自2019年1月以来，每个索赔人的手术服务费用增加了76%.

因此，所有这些领域都是导致病情加重的重要因素.

TK: Can you tell me more about social inflation and in particular “nuclear” settlements and how they are impacting liability claims?

NT: Sure. “社会通货膨胀”广义地描述了由于诉讼和解增加而导致索赔成本上升的趋势, larger jury awards, 原告律师越来越多的反公司偏见和咄咄逼人的策略.

We go into this in more detail in our Annual Trends Report but the average size of jury awards is increasing dramatically – they are up a whopping 1000% from 2010 to 2018. This includes a now infamous $1B verdict against two trucking companies in Florida as a third-party auto liability claim. The bottom line is that experienced adjusters play a key role in helping to prevent these claims going all the way to litigation and that is an area that is challenging right now to get this level of expertise in the claim workflow.

TK: 你之前提到远程工作是保险行业的变化之一. Are there other things that are changing how work, particularly for third party claims teams is changing?

NT: Yes, 根据美国互助亚博真人官方版APP协会最近的一项研究, over the next 15 years, 50% of the current insurance workforce is going to retire. This will leave more than 400,该行业有不到25%的35岁以下的职位空缺. As a result of this great resignation/transformation, 我们看到有几十年经验的理算员辞职, retiring or moving to new industries. 这尤其给第三方汽车行业留下了知识空白, 对于新的调整人员来说，这是一个新出现的挑战，需要加快最佳实践的速度.

So, to summarize, the new insurance workforce is going to be younger, less experienced, 而且预计会比前几代人更频繁地搬家.

This leaves carriers with a key challenge: how can we train adjusters more quickly and allow them to be collaborative in an environment where they aren’t physically together and may have a shorter tenure?

TK: 考虑到这个不断变化的环境，一些顶级运营商现在在做什么?

NT: There are really five key strategies that we are seeing implemented to overcome the challenges we have discussed.

1. The first strategy is continuing the focus on BI cost containment and using some of the new tools available whether that be additional bill review benchmarks, direct provider negotiations, 或者我们最近引入的利用提供商网络进行第三方支付的功能. 这些功能还具有提高精度和减少调节器工作量的好处.
2. 第二个关键策略是在第三方索赔流程中增加分析和见解的使用. This includes using real-time data access and ad-hoc analysis tools to get to the insights that matter most for claim teams.
3. 工作流自动化是第三个需要关注的策略，因为它可以帮助缓解第三方劳动力压力. 到目前为止，自动化的焦点主要集中在第一方和工人的赔偿索赔处理上, but in order to make up for some of the gaps in staffing, 通过自动化低价值任务来提高调节器的效率是很重要的, such as fee look-up and core bill pricing, 同时在理赔评估过程中支持理赔员的批判性思维.
4. A fourth strategy is staff augmentation and that is an area we have seen success since this help claims organization meet staff shortages. By working with a partner such as Enlyte, we are able to leverage cutting-edge technology and best-in-class approaches to outsourced services to optimize things like document processing & bill review workflows. 我们帮助利用规模使这些基于技术的亚博真人官方版APP成为同类中最好的.
5. The final strategy and one that really hits at the heart of so many of the trends we have talked about so is far is providing adjusters with decision support and best practice guidance. 新一代的调理员刚刚进入这个行业，他们的经验将会更少, and a key strategy is looking for ways to build better decision support and guidance into their workflow tools.

TK: On decision support, 第三方索赔处理的一些关键基础是什么, 为什么你建议运营商把重点放在正确的步骤上?

NT: Much of this is just best practice claims handling, 但对于第三方来说，我们都知道这些索赔可能是最复杂的. So, 这就是在您的组织中构建和标准化最佳实践的关键所在. In many ways, these tools can help institutionalize the experience and knowledge that is going to be leaving your organizations with adjuster retirements over the next few years.

Another key foundation that third party organizations should focus on is how they’re integrating the tools that the adjusters are using on their desktops. 我认为为调整员提供一个完整的工具箱是一回事, everything that they would need to handle a claim, 但如果你不注意如何整合这些工具并使它们协同工作, the best tools may be underutilized because the workflow ends up being disjointed and adjusters are just looking to get the next task off their desk.

Additionally, 确保调整人员有最好的见解，并有他们需要的信息, when they need it, again to boost decision support and organizational efficiency, is key. 首先把注意力转移到这些至关重要的步骤上, 运营商可以提高生产力，减少不一致和其他主要障碍, leading to better customer outcomes.

TK: Mitchell Third Party Auto如何帮助解决这些问题?

NT: Mitchell’s leading end-to-end third party liability solutions combines powerful software with technology-enabled services to help improve consistency, efficiency and overall claim outcomes. 我们的亚博真人官方版APP帮助第三方运营商提高底线结果，并提高第三方索赔的一致性, accuracy, and efficiency through integrated, seamless tools. 随着劳动力的转变，运营商能够实施他们的最佳实践并保留知识.

TK: Thanks, Norman. 关于第三方趋势的更多见解和其他有价值的信息&C industry, check out the Annual Trends report .