Workers’ Compensation

Automating Workers' Compensation Claim Processes

Michael Desrochers
November 10, 2023
5 min read

Empowering Efficiency

In today's ever-evolving workplace, navigating the growing complexity of workers’ compensation claims has become a significant challenge to insurance carriers. The need for automation in workers' compensation claim management has never been more crucial.

Traditional legacy systems that were once effective in managing workplace injuries are no longer equipped to handle the intricacies of modern workplace hazards, as well as keeping up with constant regulatory and legislative changes.

According to McKinsey, by 2030, it predicts that manual processes within both underwriting and claims will no longer exist for most property and casualty insurance. Automation in the insurance industry is the future for carriers to transform their business, maintain profitability, adjust to market changes, and stay ahead of their competition.

What does it mean to automate?

In simple terms, automation is using technology to perform tasks or deliver services with reduced or minimized human interaction.

Below are various approaches to automation. Insurance carriers need to review their current best practices and existing processes to determine what approach makes sense for them from an investment perspective as well as how it aligns with their technology transformation strategy.

  • Basic automation approach is to streamline and centralize simple day-day tasks to accelerate work, such as leveraging Robotic Process Automation (RPA) for example.
  • Process driven automation approach is to refine complex multi-step procedures by automating various systems across (rules-based decisioning) the organization, like leveraging Business Process Management (BPM) for example.
  • Advance automation approach is a combination of Robotic Process Automation (RPA), Business Process Management (BPM), Artificial intelligence (AI) and Machine learning (ML) capabilities. This approach optimizes business processes and decision-making on a larger scale.

There are several use cases within the workers’ compensation insurance lifecycle for automation, here are just some examples.


  • FROI claims intake
  • Injury investigation and assessment
  • Settlement and benefit analysis

Policy / Underwriting

  • New policy issuance
  • Risk assessment (accurate pricing)
  • Processing loss runs and payroll uploads

What are some benefits of automation?

Implemented properly, automation can be your best friend, helping spur growth and productivity throughout your overall business operation.

Boost Customer Experience

Removing inefficient service by centralizing all communications (including inbound and outbound emails), sending automated updates on claim progress, allowing for more visibility and faster decisions.

Increase Efficiency

Streamlining repetitive and time-consuming tasks reduce the likelihood of errors, minimize processing times, and ultimately improve the overall experience for injured workers, employers, and insurers.

Improve Accuracy and Compliance

Automating certain tasks enhances accuracy and compliance with regulations and identifying patterns through analyzing data, reducing the likelihood of fraud, and ensuring accurate distribution of benefits.

Enhance Risk Assessment

Enabling the collection and analysis of vast amounts of data, allowing for more accurate risk assessments, improving workplace safety, and reducing the number of workers' compensation claims.


It's time to leave behind the outdated legacy systems and move towards a more automated and effective workers' compensation claims management approach.

Overall automation can play a significant role in streamlining claims management, allowing better workflows to ensure that claims are handled promptly and efficiently, reducing the risk of delays and bottlenecks. By leveraging cloud-native digital solutions, insurance carriers can create more efficient and effective processes that expedite claim resolution, provide faster medical intervention for injured workers, and ultimately lead to better recovery and return-to-work outcomes for injured workers.

PCMS Atlas for Workers’ Compensation is designed to streamline the entire claims process, from initial First Report of Injury (FROI) reporting to final settlement/resolution.  Atlas can reduce claim cycle times, provide a better customer experience, and ensure secure and efficient data storage and sharing.

Michael Desrochers
November 10, 2023
Share this post: