Decision Support Systems: Do They Have a Role in Benefits Administration?

By Gary Anderberg, PhD

Senior Vice President, Claim Analytics
Gallagher Bassett

Decision support systems (DSSs) are proliferating in underwriting and the handling of property/casualty claims. A claims DSS employs a combination of artificial intelligence and machine learning to create a new form of subject matter expertise to advise adjusters. The primary roles of DSS assistants now are in setting reserves and in identifying claims that may benefit from interventions. Does DSS technology have a role to play in nonoccupational disability for absence managers?

A proven area of effectiveness for DSSs is the search for outliers — claim events that arrive looking like routine claims but turn into anything but routine. Claim managers call these the “creeping cats.” In disability, these are the seemingly simple short-term disability (STD) events that turn into long-term disability (LTD) claims we remember due to litigation, medical challenges, or other blind-side surprises. Experienced absence managers sometimes see these coming, but the patterns may be hard to spot in the first few months.

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