GL Solutions Flashcards
GL Solutions
Written 9-13-19 / Updated: 9-13-19
Category: Claim Services
When to Use:
Topic Intro / Why
I don’t know if you’ve recognized just how aggressive the plaintiff attorney bar has become. If you turn on your tv, radio or even drive on the freeway, you see a much more aggressive advertising about the need for an attorney if you have a GL claim. What we are doing in the GL space is we are looking at how do we overcome that big hurdle of the aggressive plaintiff atty. Travelers has access to an extreme amount of data on every claim and across our entire claims org as well as info on specific attorneys and law firms. We are using that data and creating a tool that will help our claim professionals have information at certain points in time to allow them to build strategies to manage the claim and have the best outcome.
With all the data, we’ve created a tool that we think will help us identify attorney behaviors so that when we get a specific attorney, we can match that attorney with the right claims and medical resources - so that we have the information to build a strategy to resolve the claim quickly and efficiently.
Why Does This Matter
We are seeing litigation on claims of smaller dollar value that we’ve never seen before. Atty involvement is increasing the cost of GL claims.
How
Travelers has statistics on 1,500 unique data elements that we may access, as needed, on every claim: huge number of medical bills, 200,000 attorneys, over 50,000 legal firms on plaintiff side - we have access to all of this. By tapping into all of that data, we can build tools that create models for us that can run behind the claim and send alerts and notifications to claim handler.
What’s In It For Me
You are getting the right resources on the claim faster and this tool will help shorten the duration, identify propensity for having litigation of claims and resolving them faster. Another tool is helping the claim professional when we identify an attorney we have history on; the claim professional can put forth a strategy because we know how the attorney will behave - we can put together a plan faster and will look for a more reasonable resolution than is being requested.
Attorney Analytics Slide available
The Ask
GL has traditionally been a line of business that carriers add more resource to or add more attorneys to. We are looking at coming up with solutions and tools that get to the root of the problem. One root is litigation. Another is how do you access all of the info that we have avail thru social media. It is a window to who they really are vs. what they are presenting to us on the claim. We don’t control the litigation piece because it’s a societal issue - we have also expensive jury verdicts & behavior - they feel that someone has to pay - increases the need for GL rate. We are we are going is we are coming at that issue with other solutions and you are getting something for the rate ask. We have seen an incredible increase in medical dollars on GL claims in the last several years.
Other Possible Conversation Elements
How you use social media - not something we had access to before - majority of people in your office are probably on at least one form of social media - so there is a lot of info to access there - we partnered with social media aggregator - this company pulls all of that pertinent data from all social media source and culls through them and find specific elements that would be of most value to claim handler. System runs behind the scenes. Provides claim handler with info around physical activity, financial considerations, unlawful behavior, employment - so claim professional can use it - maybe there is a contradiction to what they have on the claim - they can use it as part of their negotiation strategy. We use this in every line of business.
Other Possible Conversation Elements
One of the leading indicators we have seen driving GL costs over last 10 years is medical, up 60%. Now, medical is about 35% of the overall claim costs. To get ahead of it as a carrier and to be able to management, you have to build solutions around managing your medical. At Travelers, we uses nurses on our WC line, we have embedded nurses on our GL line as well. Having a GL nurse with a strong background in liability issues and being able to understand the medical piece is an advantage for us. They are able to identify when there is an injury, what is reasonable treatment associated with that type of injury.
We also have a bill review resource we use on GL bills; when we get packet from plaintiff attorney, we go through it, review reasonable treatment, duplicates, and taking them and reducing them to usual and customary - negotiation tool for the medical. Accessing specialized medical, audit and review team - applying resource to GL space to help us understanding (also use it in WC) - they are looking at hospitalization bills, the need for durable medical equipment and something that is more complex and identifying cost savings plus they help us see trends in a particular industry. The other piece is we have a dedicated group that looks at medical fraud because it is one of the largest areas of fraud in the U.S. resulting in billions of dollars of losses per year. our dedicated medical investigative fraud unit helps to identify and prevent medical fraud. We actually have tch built into our systems to help us i.d. fraud and accuracy of treatment records.
Technology has provided us access to info we’ve never had before and one of the ways GL is using tech is in a vendor tool called Authentic 4D. This helps us to determine if an injury is real based on the radiology film. This reviews MVRs and x-rays to help determine if the injury is real, exaggerated and totally unrelated. Powerful tool to put in hands of claim professional because it will cut down on the fraud and exaggeration piece of a claim.
