predictive modeling
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Predictive Modeling. An Overview of Analytics in Claims Management William J. Lentz, CPCU, ARe. What We Will Discuss. What Is Predictive Modeling?. Application of Analytics to Claims Management. Who Is Using It?. Considerations. Predictive Modeling. What Is Predictive Modeling?. - PowerPoint PPT PresentationTRANSCRIPT
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Predictive Modeling
An Overview of Analytics in Claims Management
William J. Lentz, CPCU, ARe
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What We Will Discuss
Predictive Modeling in Claims Management | Bill Lentz | August 2014
What Is Predictive Modeling?
Application of Analytics to Claims Management
Who Is Using It?
Considerations
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• 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
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Data-mining Software
Database
What Is Predictive Modeling?
Predictive Modeling in Claims Management | Bill Lentz | August 2014
Uncover Trends or Relationships
Correlation Among Factors in the Data
Updated Daily
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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
Claimant Profile
Nature of Injury
Treatment Venue
Representation
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Use in Claims Management
Application of Analytics to Claims Management
Predictive Modeling in Claims Management | Bill Lentz | August 2014
Potential Fraud Detection
Subrogation Potential
Reserve and Settlement Values
Litigation Management
Managing Outlier Claims
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Strategic Goals
Predictive Modeling
Predictive Modeling in Claims Management | Bill Lentz | August 2014 7
Improved Decisions
Improved Outcomes
More Efficient Claims
Management
Efficient Use of Clinical Resources
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Large Carriers
Who Is Using It?
Who Is Using It?
Predictive Modeling in Claims Management | Bill Lentz | August 2014
Middle-size Carriers
Small Carriers
Corporate Risk Management
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5 Stages of Design and Implementation
Considerations
Predictive Modeling in Claims Management | Bill Lentz | August 2014
Project Design and Planning
Data Analysis, Cleansing, and Staging
Building, Testing, and Validation
Integration of the Model
Modeling Monitoring and Management
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Considerations
Considerations
Sources and Quality
Data
Data Integrity is Essential
Proper Use of Modeling
Culture
Resistance to Use of Modeling
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Predictive Modeling is a way to
automate decisions
Myths
Considerations
Predictive Modeling allows carriers to do more
with less people
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• 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
Considerations
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Future Technological Advances
Investment Required
FinalThought
s
Predictive Modeling
Analytics Can Be an Effective Tool
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Visit genre.com for more info.
Thank youWilliam J. Lentz, CPCU, ARe +1 212 341 [email protected]