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Proprietary and Confidential | © General Reinsurance Corporation Predictive Modeling An Overview of Analytics in Claims Management William J. Lentz, CPCU,

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Presentation on theme: "Proprietary and Confidential | © General Reinsurance Corporation Predictive Modeling An Overview of Analytics in Claims Management William J. Lentz, CPCU,"— Presentation transcript:

1 Proprietary and Confidential | © General Reinsurance Corporation Predictive Modeling An Overview of Analytics in Claims Management William J. Lentz, CPCU, ARe

2 Proprietary and Confidential | © General Reinsurance Corporation What We Will Discuss Predictive Modeling in Claims Management | Bill Lentz | August 2014 2 What Is Predictive Modeling? Application of Analytics to Claims Management Who Is Using It? Considerations

3 Proprietary and Confidential | © General Reinsurance Corporation Using past events to anticipate the future The use of statistical analytical techniques to identify patterns among factors of past events These patterns are used to develop models which predict the likelihood of future events or behaviors Predictive Modeling What Is Predictive Modeling? Predictive Modeling in Claims Management | Bill Lentz | August 2014 3

4 Proprietary and Confidential | © General Reinsurance Corporation Data-mining Software Database What Is Predictive Modeling? Predictive Modeling in Claims Management | Bill Lentz | August 2014 4 Uncover Trends or RelationshipsCorrelation Among Factors in the Data Updated Daily

5 Proprietary and Confidential | © General Reinsurance Corporation Predictive models review historical claims data comparing factors associated with past losses against new and pending claims. Use in Claims Management Application of Analytics to Claims Management Predictive Modeling in Claims Management | Bill Lentz | August 2014 5 Claimant Profile Nature of Injury TreatmentVenue Representation

6 Proprietary and Confidential | © General Reinsurance Corporation Use in Claims Management Application of Analytics to Claims Management Predictive Modeling in Claims Management | Bill Lentz | August 2014 6 Potential Fraud Detection Subrogation PotentialReserve and Settlement Values Litigation ManagementManaging Outlier Claims

7 Proprietary and Confidential | © General Reinsurance Corporation Strategic Goals Predictive Modeling Predictive Modeling in Claims Management | Bill Lentz | August 2014 7 Improved DecisionsImproved Outcomes More Efficient Claims Management Efficient Use of Clinical Resources

8 Proprietary and Confidential | © General Reinsurance Corporation Large Carriers Who Is Using It? Predictive Modeling in Claims Management | Bill Lentz | August 2014 8 Middle-size Carriers Small Carriers Corporate Risk Management

9 Proprietary and Confidential | © General Reinsurance Corporation 5 Stages of Design and Implementation Considerations Predictive Modeling in Claims Management | Bill Lentz | August 2014 9 Project Design and Planning Data Analysis, Cleansing, and Staging Building, Testing, and Validation Integration of the Model Modeling Monitoring and Management

10 Proprietary and Confidential | © General Reinsurance Corporation Considerations Predictive Modeling in Claims Management | Bill Lentz | August 2014 10 Sources and Quality Data Data Integrity is EssentialProper Use of Modeling Culture Resistance to Use of Modeling

11 Proprietary and Confidential | © General Reinsurance Corporation Predictive Modeling is a way to automate decisions Myths Considerations Predictive Modeling in Claims Management | Bill Lentz | August 2014 11 Predictive Modeling allows carriers to do more with less people

12 Proprietary and Confidential | © General Reinsurance Corporation Predictive Modeling can enhance good claim handling – it cannot rectify poor claim handling Not a substitute for proper claim management methods Does not take the place of individual claim analysis Supplement and support decision making process Considerations Predictive Modeling in Claims Management | Bill Lentz | August 2014 12

13 Proprietary and Confidential | © General Reinsurance Corporation Future Technological AdvancesInvestment Required Final Thoughts Predictive Modeling Predictive Modeling in Claims Management | Bill Lentz | August 2014 13 Analytics Can Be an Effective Tool

14 Proprietary and Confidential | © General Reinsurance Corporation Visit genre.com for more info. Thank you William J. Lentz, CPCU, ARe +1 212 341 8087 wlentz@genre.com


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