THE CHALLENGE
Slow claims handling was holding workers back from returning
Workers’ compensation claims often run into thousands of pages of attorney and medical notes, which creates its own challenges. While verifying claims, insurers must take into account workplace safety, the type of job and accident, and geography, which can sometimes take years, even decades, to resolve. The faster the claims get processed; the quicker employees can get back on their feet—and to work.
At EPIC, they were processing over 3,000 claims per year; each claim averaging 50 pages of attorney and medical notes, all bundled into 1,000+ page notebooks. The company spent excessive time manually searching through lengthy worker injury claims, leading to delays in decision-making and missed opportunities.
COMPANY
EPIC Insurance Brokers & Consultants
HEADQUARTERS
San Francisco, California
INDUSTRY
EMPLOYEES
3000
FEATURED SERVICES:
“ We realized we had a massive store of unstructured data that was being underutilized and we engaged with OZ and got a deployable AI tool in a remarkably short time. ”
— Patrick Gallagher, Chief Growth Officer, Risk Management, EPIC Insurance Brokers
BUSINESS NEED
Efficient claims handling to get workers back on the job sooner
There had to be a smarter way of managing claims processing. They realized they had to transform traditional processes into more efficient operations to drive profitability and customer satisfaction. By embracing AI, they realized they could unlock new opportunities for growth, innovation, and competitiveness.
THE SOLUTION
An Azure OpenAI solution to accelerate claims management
EPIC partnered with OZ Digital Consulting to create an Azure OpenAI-powered system to automate the
categorization and analysis of claims data, providing a plain language search interface for quick,
accurate insights. And what the AI could do—where a small team previously with spreadsheets
couldn’t—was spot trends in the data from thousands of pages in minutes. It can go into details such as, which group of workers were able to go back to work faster? What physician were they seeing? What type of physical therapy were they engaged in? What type of medication were they prescribed? And connect the data, impossible for humans to do—at scale.
IMPACT
Faster claims processing, swifter return to productivity
The AI solution has increased efficiency, along with a slew of other benefits, notably:
• Improved decision-making
• Enhanced risk management
• Better compliance
• Reduced operational costs through streamlined data retrieval and analysis
