Coming Together to Make those Claim Management Efforts More Fruitful

Human beings may have done a lot throughout their history, but the impressive thing would be how they have been able to get better under all circumstances. This progressive approach, on our part, has already got the world to hit upon some huge milestones, with technology appearing as a major member of the stated group. The reason why technology enjoys such an esteemed stature among people is, by and large, predicated upon its skill-set, which ushered us towards a reality that nobody could have ever imagined otherwise. Nevertheless, if we look up close for a second, it will become clear how the whole runner was also very much inspired from the way we applied those skills across a real world environment. The latter component was, in fact, what gave the creation a spectrum-wide presence, and consequentially, kickstarted a tech revolution. Of course, this revolution then went on to scale up the human experience through some outright unique avenues, but even after achieving such a monumental feat, technology will somehow continue to produce the right goods. The same has grown increasingly evident over the recent past, and assuming one new insurtech-themed development shakes out just like we envision, it will only make that trend bigger and better moving forward.

Gradient AI, a leading enterprise software provider of artificial intelligence (AI) solutions in the insurance industry, has officially announced the decision to expand its partnership with MEMIC, an A.M. Best “A” (Excellent) rated workers’ compensation insurer. Under the freshly-hashed out terms, MEMIC is expected to bank upon Gradient AI’s Claims Benchmarking solution to scale up its claims management operation. You see, by leveraging the stated set of solutions, the company will be able to identify all trends and outliers lurking on the horizon. This, in turn, should inform MEMIC’s decisions for the future, while simultaneously refining its reserve management processes, therefore making sure that sufficient funds are always set aside to address anticipated claim costs. Talk about the technology in focus here, Gradient AI’s benchmarking solution works alongside industry-leading data lake containing tens of millions of claims and policies. Such an expansive data repository, like anyone would guess, can come in handy when the goal is to help users see how their claims’ reserves compare to similar industry claims. Not just comparisons, it can also facilitate any assessment of whether the reserve for a specific claim is on target or needs attention because it is over or under-reserved. Moving on to why MEMIC’s presence makes the whole development even more significant, the company is currently serving more than 20,000 employers and their estimated 300,000 employees with dedicated safety and injury management service teams. Considering at any given time MEMIC is working on over 11,000 open claims, it becomes absolutely crucial yet difficult for the company’s claim managers to be accurate in regards to setting future reserves. Fortunately, to further aid their case, these managers will now also have a Total incurred Prediction solution at their disposal, a solution which will predict future costs on a case-by-case basis.

“MEMIC’s visionary approach to unleashing the potential of data within its workers’ comp claim operations is commendable,” said Stan Smith, CEO and founder of Gradient AI. “Through strategic benchmarking against industry-wide data, and leveraging powerful predictive insights, the company is poised to elevate the precision of its case reserves, amplify claims management effectiveness, and enhance its ability to grow profitably. We are proud to provide industry-leading underwriting and claims management solutions and thrilled to continue to support MEMIC on its journey toward greater excellence.”

But what makes Gradient AI an ideal partner for this sort of effort? Well, the answer is present in the company’s ability to improve loss ratios and profitability by predicting underwriting and claim risks with greater accuracy. In case that’s not enough, Gradient AI can also reduce quote turnaround times and claim expenses through intelligent automation. Now, we did cover the company’s enormous data lake, but another element keeping it ahead of all competitors is the way it accommodates plenty other features, including economic, health, geographic, and demographic information. This very versatility is what has helped Gradient AI in being a trusted partner for everyone from MGAs, MGUs, and TPAs to risk pools, PEOs, and large self-insured employers across all major lines of insurance.

“Our claim team is excellent but Gradient AI takes our game to a new level,” said Matt Harmon, SVP of Claims at MEMIC. “The benchmarking tool compares individual claims to similar industry claims. It highlights those claims deviating from norms, enabling us to decide if reserve levels are adequate. Adequate reserves create greater accuracy when calculating experience modification factors, and in turn better serve the interest of the policyholder and MEMIC alike. While we have engaged with other AI providers, Gradient AI stands apart by introducing reserve-based solutions that are truly game changers. The inclusion of both benchmarking and predictive tools represents new and exciting territory for us.”