Predictive Modeling Applications in Actuarial Science
 Volume 1
 Introduction
 Predictive Modeling Foundations
 Predictive Modeling Methods
 Bayesian and Mixed Modeling
 Longitudinal Modeling
 Volume 2
 Generalized Linear Model
 Extensions of the Generalized Linear Model
 Unsupervised Predictive Modeling Methods

Applications on Current Problems in Actuarial Science
 Chapter 8  The Predictive Distribution of Loss Reserve Estimates over a Finite Time Horizon
 Chapter 9  Finite Mixture Model and Workersâ€™ Compensation LargeLoss Regression Analysis
 Chapter 10  A Framework for Managing Claim Escalation Using Predictive Modeling
 Chapter 11  Predictive Modeling for UsageBased Auto Insurance
Chapter 10  A Framework for Managing Claim Escalation Using Predictive Modeling
Authors
Mohamad A. Hindawi  Allstate Insurance Company
mhindawi@gmail.com
Claudine H. Modlin  Willis Towers Watson
Claudine.modlin@towerswatson.com
Chapter Preview
This chapter discusses a type of predictive modeling application commonly referred to as claims triage. The broad objective of claims triage is to use the characteristics of each individual claim at a specific point in time to predict some future outcome, which then dictates how the claim will be handled. In practice, claims triage might identify simpler claims for fasttrack processing or alternatively identify complex claims that require expert handling or intervention. Claims triage models can help assign claims to the right adjuster or inform the adjuster of what actions to take (e.g., when to dispatch an engineer to a claim site or when to assign a nurse case manager to a workersâ€™ compensation claim).In this chapter, we discuss a specific application that seeks to identify those claims that have a higher likelihood to settle far in excess of early reported loss estimates. This early identification of likely claim escalation should enable the claims department to better manage and potentially mitigate the escalation. Much of our discussion is based on application to workersâ€™ compensation claims, but the methods and issues discussed can be relevant to other longtailed lines with sufficient claims volume such as general liability.