Accurately assessing the severity of an injury when a claim is first filed is a critical step in workers’ compensation insurance. Yet for many insurers, getting it wrong can lead to delayed recoveries, higher costs, and dissatisfied clients. At Zenith Insurance Company, Devidas Kanchetti is tackling this challenge head-on with an innovative AI-driven system that’s transforming the way claims are managed. Here’s how his team’s work is making a difference.
Seeing the Problem Clearly
For years, Zenith Insurance faced a common yet costly issue: the inability to accurately gauge the severity of injuries at the initial claim stage. Misjudgments often meant that serious cases didn’t receive the urgent attention they required, while milder injuries sometimes consumed unnecessary resources. The result? Extended recovery times, ballooning costs, and frustrated injured workers.
“Assessing injury severity accurately and early is crucial,” says Kanchetti. “Our goal was to use AI to get ahead of these challenges, allowing us to triage effectively from day one.”
Building a Smarter System
Kanchetti and his team set out to create a real-time injury severity prediction system that would empower claims adjusters to make better decisions right at the point of claim intake. They gathered data from various sources, including initial injury reports, medical assessments, and even workplace safety records. By analyzing these inputs, they could identify key factors—like injury type, worker age, and job role—that influence recovery outcomes.
The team employed advanced machine learning techniques, including Gradient Boosting Machines, Neural Networks, and Decision Trees, to build predictive models. They also developed a severity scoring system to categorize injuries, making it easier for adjusters to prioritize cases based on urgency.
“Building the model was a complex process,” Kanchetti explains. “But we knew that with the right data and the right algorithms, we could make a real impact on how injuries are managed.”
Real-Time Impact
The AI system was integrated directly into Zenith’s claims management platform, enabling real-time injury assessments. This meant that as soon as a claim was filed, the system could instantly predict the injury’s severity and recommend the appropriate course of action.
The results were immediate and impressive: the accuracy of claim triage improved by 45%, ensuring that high-severity cases were quickly identified and prioritized. This not only sped up recovery times but also helped reduce overall claim costs by 20%.
Positive Outcomes for All
Perhaps most importantly, Kanchetti’s system is making a difference where it matters most—helping injured workers get the care they need to return to work faster. The AI-powered predictions contributed to a 15% reduction in the average duration of severe injury cases, a significant improvement that has led to better outcomes for both employees and employers.
Claims adjusters, who often face the daunting task of managing numerous cases with limited resources, have also benefited. They report higher satisfaction levels, citing the system’s ability to simplify decision-making and provide better support to injured workers.
“This technology is a game-changer,” says one claims adjuster. “It takes a lot of the guesswork out of the process and lets us focus on helping people recover.”
Scaling for the Future
Designed with flexibility in mind, the system has already begun scaling across different regions and industries. Its adaptability to various types of workplace injuries and regulatory environments means it has the potential to set a new industry standard.
“We built this system to be scalable from the start,” Kanchetti notes. “It’s exciting to see how it’s not just solving problems today but also paving the way for future innovations in the industry.”
About Devidas Kanchetti
Devidas Kanchetti is a trailblazer in the field of data and analytics, with over 14 years of experience applying AI and machine learning to solve complex problems across multiple industries. Currently the Data Analytics Lead at Zenith Insurance Company, Kanchetti is known for his hands-on approach to integrating cutting-edge technology into traditional business processes. His work not only enhances efficiency and accuracy but also focuses on delivering tangible benefits for the end-users, from claims adjusters to injured workers.
Beyond his professional achievements, Kanchetti is committed to nurturing the next generation of data professionals, actively mentoring young talent and sharing his insights on the evolving role of AI in business. His dedication to continuous learning and his passion for making data work for people make him a respected leader in the field.
