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AI and Its Impact on Automotive Claims

For more than six decades, innovators have attempted to unlock the full potential of artificial intelligence (AI). It wasn’t until the past decade that the science finally caught up to expectations. Today, the AI market is on track to reach $500 billion by 2024. COVID-19 has fast-tracked AI adoption and acceptance.

McKinsey & Company says that “insurance will shift from its current state of ‘detect and repair’ to ‘predict and prevent,’ transforming every aspect of the industry in the process.”

See also: Key to Transformation for Auto Claims

AI-enabled solutions have opened up new possibilities for auto insurers and collision repairers. From detecting a car accident with IoT technology, to instantly processing a payment for completed repairs, the opportunities are endless. First on the list for most carriers, however, is using AI to automate the appraisal process and produce a “touchless” estimate. This can improve efficiency, shorten cycle time and meet policyholder expectations for a streamlined, digital claims experience. Now, thanks to these four trends, creating that experience is within reach.

1. Shifting Methods of Inspection

Prior to COVID-19, virtual estimating was reserved for low-severity claims. However, the need for social distancing during the pandemic and changing consumer demands spurred the adoption of virtual inspection methods. In April 2020, Mitchell data shows that the use of virtual, or photo-based, estimating more than doubled from earlier in the year. Just one year later, LexisNexis Risk Solutions reported that virtual claims handling has now “settled to a level of a little over 60%.”

This shift opened the door to the long-term aspiration of “touchless” claims and leveraging AI in the appraisal process. Over the last year, virtualization—considered the first level of automation—has resulted in estimate efficiency and consistency gains. From images, appraisers can complete approximately 15 to 20 estimates per day versus three to four out in the field. This has prompted more carriers—nearly 70%, according to LexisNexis Risk Solutions—to embark on the claims automation journey.

2. The Prevalence of Big Data

According to the Center for Insurance Policy and Research, “The successes of AI are also being facilitated by the massive amounts of data we have today. The wealth of data we now create is astonishing, and the speed at which data is generated has only made data management tools like AI even more important.”

The property and casualty industry has always thrived on capturing, analyzing and interpreting data. Whether it’s from mobile devices, automobile IoT sensors or other sources, this data gives decision makers the information necessary to personalize customer interactions and address issues. When it comes to touchless estimating, though, data alone isn’t enough. Access to a comprehensive library of vehicle, repair and historical claims information is needed—along with the ability to quickly interpret that information using AI. In the case of Mitchell Intelligent Estimating, claim details and images are collected. AI then analyzes the data, comparing it with Mitchell’s comprehensive library of vehicle and repair information that spans more than 30 years. From there, the machine-learning algorithms translate the output into component-level estimate lines for appraiser review and approval.

3. Human-Machine Collaboration

Just as humans continually learn and improve, so do machines. As highlighted in Insurance Thought Leadership, “good machine learning systems involve feedback loops…. By letting the machine know what happens on the ‘real world’ side of things, machines learn and improve”—no different from claims adjusters!

Support for a human-machine feedback loop is critical to automating the claims process and can lead to vast improvements in speed and accuracy. An appraiser’s feedback helps teach the machine to make better decisions. As AI-powered solutions remove repeatable tasks, employees have more time to focus on complex claims that may require extra scrutiny.

4. The Growth of Cloud Computing and Open Ecosystems

AI’s dependence on data increases the need for cloud-based systems that can access and aggregate vast amounts of information, making it available from anywhere. These systems help organizations reduce development and maintenance costs, enhance security and accessibility and improve speed, reliability and scalability.

Like cloud computing, open ecosystems are also vital to AI and touchless estimating. Open ecosystems allow AI to easily access data, analytics and software across platforms and providers, giving carriers the ability to create a cohesive, end-to-end claims experience. They also introduce flexibility and choice, PropertyCasualty360 reported.

See also: Designing a Digital Insurance Ecosystem

For instance, through Mitchell Intelligent Open Platform, carriers can select the AI that best meets their needs. That includes AI algorithms developed internally, provided by Mitchell or delivered through third parties such as Tractable or Claim Genius. The AI output is used to produce a partial or complete appraisal.

The Future of AI-Enabled Claims

By 2030, McKinsey & Company predicts that more than half of current claims activities will be replaced by AI-enabled automation. “Claims for personal lines and small-business insurance are largely automated, enabling carriers to achieve straight-through processing rates of more than 90% and dramatically reducing claims processing times from days to hours or minutes.”

With the science now ready to deliver on its decades-old promises, the auto insurance industry has reached a turning point. Carriers can either invest in AI or run the risk of being stranded by the side of the road. Ultimately, organizations that embrace this “new” technology to deliver a digitally driven claims experience will be best-positioned to gain market share and consumer loyalty.

The Need to Protect Healthcare Workers

The National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) just released their Hospital Respiratory Protection Toolkit. This toolkit provides a much-needed comprehensive resource for healthcare employers to use to protect their staff from respiratory hazards like airborne infectious diseases, chemicals and certain drugs that, when inhaled, cause illness, infection or other physical harm to healthcare workers.

We know that national public health preparedness has increased because of the Ebola virus cases in Dallas last year, but the nation may not know that federal agencies like NIOSH and OSHA are always working to prepare healthcare and other workplaces from exposures to dangerous organisms and chemicals that cause infection, illness and other harm. This new toolkit is evidence of that effort. According to the International Safety Center and its EPINet data, current compliance with the use of personal protective equipment (PPE) like respirators, and even lesser protection like surgical masks, is so low (less than 20%!) that this effort can only help to improve compliance.

The OSHA Respiratory Protection Standard has long required that healthcare employers have a respiratory protection program to protect workers exposed to respiratory hazards, but the standard is as complex as are the hazards and the circumstances surrounding patient care in hospitals. This toolkit helps healthcare and program administrators sort through the standard, overcome what they may see as daunting tasks and tackle their respiratory protection programs one step at a time.

The toolkit is long — 96 pages long — but fear not. It provides great pull-out, grab-and-go tools like the “Respiratory Protection Program evaluation checklist” and a “Respiratory Protection Program template” that can be used in healthcare facilities to create, adapt or modernize programs. Not all respiratory protection program administrators are seasoned at putting programs in place that are effective, and this resource will surely assist even the novice pull together a safe program.

Hats off to NIOSH and OSHA! You remind us that keeping our patients as safe as possible is only possible when we keep our workers as safe as possible.

Your comments about the utility of this resource would be appreciated by NIOSH, as it will help inform the development of future companion resources. You can kindly email your feedback directly to Debra Novak’s email: ian5@cdc.gov.

‘Un-Healthcare’ Work Deserves Focus

Some, like me, who have dedicated their lives to the maintenance and improvement of physical and mental health, may not consider themselves traditional, clinical “healthcare workers.” We may feel as if we work on the fringe, on the outside. We are not nurses or physicians. We work in public health, wellness, nutrition, occupational safety, health economics, fitness, risk management, pharmacy, laboratory, research, insurance and other similar non-traditional clinical professions. We may feel we make a lesser impact on patient care and overall community wellness and vitality. Given historical reference, however, this is absolutely untrue.

The term “healthcare” (whether one word or two) has not been used at all in books, papers, references or published text over hundreds of years, until the mid-1980s. But since the late 1700s, those of us “living on the fringes” have been healthcare workers in the true sense of the practice.

We may not provide bedside patient care in a healthcare or hospital setting, but we do:

  • Prevent infectious disease by promoting the use of vaccines;
  • Protect the public from pathogenic organisms through water and food sanitation;
  • Prevent addiction and antibiotic resistance through pharmaceutical stewardship;
  • Manage repercussions from post-traumatic stress with mental health interventions;
  • Research global disease trends to stop them in their tracks;
  • Manage risk by improving safety, security and improving quality;
  • Decrease work-related injury and illness by creating safe workplaces, and
  • Prevent heart disease and weight-related cancers by promoting regular exercise.

Those efforts ensure that a population’s health (both physical and mental) does not suffer, that it is either maintained or, better yet, improved. We are the “Un-Healthcare Workers.”

It is especially important that traditional healthcare organizations and healthcare workers know this now. As healthcare systems around the world are caring for patients with emerging infectious diseases like Ebola and re-emerging vaccine-preventable diseases like measles, they need to consider that we un-healthcare workers have responsibility for protecting our communities. If we can prevent diseases from becoming epidemic in our communities, healthcare providers working in healthcare settings like hospitals can focus more on providing needed care to those with emergent injuries and chronic disease.

The American Public Health Association (APHA), which has represented people protecting the public since 1872, announced a policy in November on preventing Ebola and “globally emerging infectious disease threats” that marked a significant change in the recognition of the “un-healthcare worker.” The APHA identified the need to focus efforts on preventing infectious disease in the community and workplaces as a means to protect healthcare systems from exposure to diseases that may change the overall landscape of inpatient care. In the process, the APHA advocates for the role that we “un-healthcare workers” have in maintaining and improving the physical and mental health of our population so that healthcare workers can focus on medical interventions for those who really need it.

Sound, science-based public policy and fiscally grounded public health funding can do what it did for the hundreds of years prior to the mid-1980s; it can protect our communities from disease, so that we can protect the vitality of our healthcare systems.

OSHA Should Help on Infectious Diseases

OSHA’s promulgation of an infectious disease rule/standard to protect healthcare workers and employees in healthcare facilities from microorganisms that cause illness and infection would be a welcome expansion of the work OSHA has already done related to bloodborne pathogens.

A standard of national caliber would not apply any more pressure to healthcare employers than they already place on themselves to protect the patients and healthcare workers they serve. On the contrary, a rule would highlight the importance of the safety and health of healthcare workers.

However, just when we, as a nation, are designing programs to protect healthcare workers from exposure to emerging infectious diseases, like Ebola virus, small businesses say, “No thanks, OSHA, we’re all good.” Just recently, the Small Business Advocacy Review (SBAR) Panel issued a report to OSHA Assistant Secretary Dr. David Michaels that said small healthcare businesses (to include ambulatory surgery, doctors’ offices, dental offices, specialty clinics and dialysis centers, to name only a few) weren’t interested in better protections for their workforce.

Small entity representatives (SERs) decided that the guidance that is already in place is good enough and that OSHA would just be adding more requirements. The SBAR report stated:

Many SERs felt that this rule would overlap with and/or duplicate other relevant guidelines and regulations, including, for example, materials issued by the Centers for Medicare and Medicaid Services (CMS), the Joint Commission and other voluntary accrediting organizations, and state accrediting boards.

SBAR has a point: Guidance is in place from CMS, the Joint and others, like CDC. But the guidance is almost completely to protect the patient, not the worker.

The American Public Health Association (APHA) disagrees with the SBAR panel and firmly believes that an OSHA standard should be fast tracked to protect the working public. The APHA issued a national policy statement just last month.

We learned from the Ebola exposures in Dallas that those infected after exposure were the healthcare workers, not other patients. If a patient enters an emergency department feeling generally ill, it is not typically the other patients who are potentially exposed to a yet-to-be-identified pathogen; rather, it is the string of healthcare workers with whom the patient comes into contact. Those include workers who examine the patient, take vitals, take blood or other specimens, assess, diagnosis and eventually treat. In the case of the Dallas Ebola victim, that was dozens of healthcare workers both in and outside of the hospital over more than a week’s time.

The population of healthcare workers that a standard like OSHA’s infectious disease standard could protect is vast. It is typically in smaller healthcare settings that greater protections are needed, as these operations often intersect more closely with the community and have lesser controls in place compared with hospitals or larger health systems. In fact, nearly 10% of the U.S. working population is employed in healthcare settings of all sizes, and healthcare will generate millions of new jobs through the next decade (Bureau of Labor Statistics 2013). This sector of the workforce represents the largest segment of employment growth in the U.S. and serves the largest proportions of Americans, ensuring proper and timely diagnosis, treatment and care. Healthcare employment is marked as the industry sector with the largest growth (2.4%).

Better controls to protect our most important healthcare assets — its workers — are needed now.

OSHA’s bloodborne pathogens standard (BPS) alone will not address these important and constantly emerging occupational risks associated with hazards that are not often visible to the naked eye.  Promulgating an infectious disease role nationally, much like CalOSHA did with its aerosol transmissible diseases standard (ATD, §5199), would provide OSHA the opportunity to work with healthcare facilities and providers of care to develop standards that protect their employees from not just physical or chemical hazards, but biologic ones. Healthcare facilities would have the ability to control the environment of patient care and make it safer for all who enter: patients, family, friends, volunteers, contractors and caregivers alike.

This standard, if done right, has the potential to provide the following benefits:

–       Prevent transmission of microorganisms that cause illness and infection

–       Improve safety for healthcare workers

–       Make care for patients safer

–       Increase the viability of the healthcare work force and the healthcare economy

–       Reduce costs associated with workers’ compensation, time away from work, staff turnover

–       Provide a collaborative, bridge-building role with other U.S. agencies like CMS, CDC and the Food and Drug Administration (FDA)

–       Serve as a model for other countries

OSHA’s continued journey down the path of promulgating an infectious disease standard illustrates the role that it can play in bridging the gap between infectious disease and occupational safety and health experts.