Study Shows Decade-High Demand for Claims Pros

Rising Medical Solutions’s just-released 12th annual Workers’ Compensation Benchmarking Study Report examines how claims organizations are implementing the digital transformation of their businesses while maintaining the human elements essential to optimal outcomes.
The reports findings and recommendation are organized around what the solution provider said are principal themes that emphasize the importance of innovation, technology, integration and talent development.
The report shows that 46% of claims professionals are spending 30-40% or more of their time on routine tasks, which AI and automation can reduce, freeing professionals to focus on higher-value, human-centered work.
Equally important, with demand for claims professionals at a 13-year high, the research shows how organizations are expanding recruitment pools, enhancing training programs that upskill claims staff in both emotional intelligence and the use of AI.
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Old Republic said in reporting its second quarter results, that workers’ comp continued to have strong favorable development and accounted for the majority of the total favorable development in the insurer’s insurer’s specialty insurance group.
Workers’ comp net premiums written were 2% lower in the second quarter while the loss ratio came in at 48.5 compared to 50.7 last year.
The insurer said it saw rates stay relatively flat for the second quarter, while loss frequency trend continues to decline, and loss severity trend remains stable.
“Given the declining loss frequency trend and stable loss severity trend, we think our rate levels for workers’ compensation remain adequate,” CEO and President Craig Smiddy told analysts on a conference call following the earnings report.
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Tennessee’s Court of Workers’ Compensation Claims last week deferred to an injured municipal worker’s treating physician over medical examiners, ordering an his to cover spinal surgery, provide disability benefits, and pay past temporary total disability benefits of $36,238 and $7,248 in attorney fees.
The case, Michael v. City of Pulaski Electric Systems, involved a worker injured in a 2023 incident where a bucket from a boom truck struck him on the head as it was lowered to the ground.
Following treatment and ongoing pain complaints, the city authorized him to see a board-certified orthopedic spine specialist, who recommended fusion surgery.
Pulaski then denied treatment after two independent medical examiners found inconsistencies in scans, including one who observed that the employer was a smoker, which leads to “unsuccessful fusions.”
The court explained “that no doctor has presented any other non-surgical options to relieve Mr. Brown’s complaints.”
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