Operations Research in the Insurance Industry: II. An Application in Claims Operations of Workmen's Compensation Insurance

Abstract

This paper presents an application of operations-research techniques to managing claims in workmen's compensation insurance. It describes the investigative studies and their conclusions, outlines the systems design and implementation, and gives a sample of the validation studies. Implementation of the proprietary claims-management system described has provided dramatic reductions in case durations and paid dollar losses, while returning the injured worker to his ultimate level of rehabilitation in a shorter time.