Predictive AI Optimizes Injured Worker Claims
Key Points
- The company, a leading global provider of core insurance systems, sought to improve injured‑worker claim outcomes by moving away from a “one‑size‑fits‑all” approach and better matching case‑manager skills to each claim.
- To achieve this, they partnered with IBM in a collaborative “garage” environment, assembling IBM technical experts (data modelers, data scientists, cloud specialists) alongside the company’s technology and subject‑matter experts.
- Using IBM’s Watson, they built a machine‑learning model that evaluates claim factors to predict return‑to‑work timelines, optimal treatment plans, and associated costs, continuously learning to increase confidence in its predictions.
- IBM’s value lay not only in the advanced technology but also in its expertise and structured guidance, which helped integrate diverse teams and focus on delivering measurable business results.
Full Transcript
# Predictive AI Optimizes Injured Worker Claims **Source:** [https://www.youtube.com/watch?v=Z6AnuYfM8Wk](https://www.youtube.com/watch?v=Z6AnuYfM8Wk) **Duration:** 00:01:40 ## Summary - The company, a leading global provider of core insurance systems, sought to improve injured‑worker claim outcomes by moving away from a “one‑size‑fits‑all” approach and better matching case‑manager skills to each claim. - To achieve this, they partnered with IBM in a collaborative “garage” environment, assembling IBM technical experts (data modelers, data scientists, cloud specialists) alongside the company’s technology and subject‑matter experts. - Using IBM’s Watson, they built a machine‑learning model that evaluates claim factors to predict return‑to‑work timelines, optimal treatment plans, and associated costs, continuously learning to increase confidence in its predictions. - IBM’s value lay not only in the advanced technology but also in its expertise and structured guidance, which helped integrate diverse teams and focus on delivering measurable business results. ## Sections - [00:00:00](https://www.youtube.com/watch?v=Z6AnuYfM8Wk&t=0s) **AI-Driven Injured Worker Triage** - An insurance firm partners with IBM to use Watson’s machine‑learning models for predicting return‑to‑work outcomes, enabling personalized claim triage and resource optimization. ## Full Transcript
in the insurance industry we are the
number one provider of core systems to
clients around the world in insurance we
provide business process services to the
market in particular around injured
worker claims processing we wanted to
focus on how we could enable our case
managers to help provide the most
effective outcomes for the injured
worker instead of doing a one size fits
all across injuries we needed a better
way to try to triage the claims and
determine if there was an optimal way
that we could treat injured workers as
well as optimize our resources to help
make sure we're providing the best match
between skill set and injured workers we
partnered with IBM in a garage setting
we brought a team together of IBM
technical experts around data modelers
data scientists cloud guys with some of
our technology people as well as some of
our subject matter experts what we're
using Watson Ford is a round machine
learning where we've trained and built a
model to be able to look at factors and
predict those return to work outcomes
the treatment plans and the cost so over
time we're adding more to it and helping
it learn so we can get higher confidence
levels in its predictions the value that
IBM brings is not just the technology
component the technology is outstanding
it's the expertise and guidance and
approach to help bring together people
with a variety of backgrounds in order
to focus on driving a business outcome
that's really where the value comes in
[Music]
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