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Improving workers' compensation claims outcomes by leveraging technology and enhancing communication

To navigate the complexities of workers' compensation claims, employers are leveraging technology for more effective outcomes.

04/25/2025 · 4 minute read

Every year, employers in the US spend billions of dollars to manage workers’ compensation claims, with claims resulting from accidents in 2021 and 2022 costing, on average, more than $44,000. Aside from the significant financial burden for employers, work-related injuries can have devastating effects on workers, potentially leading to lengthy absences and, in severe cases, prohibiting them from returning to work altogether.

Considering the financial and emotional toll of an injury, it is critical for employers to actively manage each claim, taking the necessary steps to provide injured workers with effective support to recover and return to the workforce. This requires identifying potentially problematic claims early in the process, and taking the required action to mitigate long-term consequences.

Streamlining claims management through tech-driven insights

To navigate the complexities of workers' compensation claims, an increasing number of employers are turning to advanced methodologies that enhance their ability to identify and manage claims effectively, allowing them to focus on the ones that require the most attention.

Predictive modeling and artificial intelligence (AI), for example, help enable risk managers to analyze historical data and evaluate the likelihood of claims becoming complex or costly.

Marsh’s Blue[i] Claims, for example, aggregates claims data from both carriers and TPAs into an easy-to-navigate dashboard that provides senior leaders with critical insights to pinpoint complex claims early in their lifecycle. This allows organizations to focus on the claims that require the most attention.

By examining various factors — such as the nature of the injury, the employee's medical history, and the circumstances surrounding the claim — organizations can flag claims that may require additional scrutiny or intervention.

These technologies can also facilitate the real-time monitoring of claims, increasing the likelihood that employers are able to respond proactively. For instance, AI-driven tools can alert claims handlers to emerging issues, such as an employee seeking legal representation, which often indicates a claim may become more expensive and protracted. By leveraging these capabilities, organizations can better marshal their resources and prioritize claims that are most likely to benefit from additional focus.

Six actions for effective claim handling

Once a potentially problematic claim has been identified, it is important to manage it effectively through a structured approach that focuses on facilitating the employee’s recovery and return to work. Key actions to manage claims that could become challenging include: 

  • Leverage tech-enabled tools to investigate claims. Effective investigations are crucial for managing costs and verifying the legitimacy of claims. Advanced tech-enabled tools — such as predictive models, social media checks, and automated medical canvases — enhance this process by facilitating timely reporting, data collection, and analysis. The right tools can allow claim handlers to identify red flags early and gather comprehensive information quickly. This not only streamlines the investigation but also supports informed decision-making, potentially leading to quicker resolutions and reduced costs.
  • Develop a customized action plan. Establishing clear action plans within the first 30 days of a claim's initiation and confirming that each step is completed is critical. Templates and checklists can help ensure that all necessary steps are documented. Predictive analytics can be used to analyze the claim's details and suggest specific actions based on historical data, helping claims handlers in their creation of tailored plans that address the unique circumstances of each case.
  • Set up technology-enabled alerts. It is important that the necessary actions are carried out in a timely manner. Technology can be used to send automated reminders to notify claims handlers of upcoming deadlines or remind injured employees about follow-ups with medical providers. This proactive approach may help minimize delays in addressing specific issues and ensure that each claim continues to be managed efficiently.
  • Engage in effective communication. Maintaining open lines of communication with injured employees is essential for fostering trust and can contribute to a smooth claims process. Claims handlers can leverage various communication channels, such as secure messaging platforms, mobile apps, texting, or automated email updates to keep employees informed about the status of their claims. Regular check-ins can help address any concerns or questions the employee may have, while AI-driven chatbots can provide prompt responses to common inquiries. Aside from reassuring employees that their claim is being handled, this level of engagement also encourages injured workers to actively participate in their recovery journey.
  • Provide additional personalized support. Identifying employees who may require more personalized care, such as the involvement of a case management nurse, can significantly improve outcomes. Data analytics programs can help detect patterns that indicate an employee may need additional support, such as prolonged recovery times or repeat medical visits. When such cases are flagged early, organizations may have the opportunity to provide additional needed resources to help improve the recovery. Personalized care plans can also include tailored rehabilitation programs and regular assessments to monitor progress and adjust treatment as needed.
  • Be aware of potential litigation signs. It is important to recognize that once an injured employee seeks legal advice, the claim may become more expensive and take longer to resolve. Predictive modeling can be employed to help identify claims that are likely to end up in litigation, allowing case managers to take preemptive measures to mitigate risks. For example, AI can analyze historical claims data to identify common factors associated with litigation, enabling risk managers to address these issues proactively. By fostering a collaborative environment and addressing employee concerns promptly, organizations can reduce the likelihood of claims escalating to litigation.

Effective management of workers' compensation claims is critical for both organizational cost control and employee well-being. By leveraging technology, including predictive modeling, and engaging in proactive communication strategies, organizations can better identify potentially problematic claims early and manage them effectively, helping to close claims and, where possible, return injured workers to their jobs.


To speak to a Marsh specialist to learn more, please contact us.

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Managing a workers' compensation file in 2025

For more information on managing workers’ compensation claims, listen to the recording of our recent webcast: Managing a workers’ compensation file in 2025.

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