Workers Comp Claims Severity Prediction

Service Offering

NLP analyzes notes to route high-severity claims instantly

Problem Statement

High-cost claims identified too late increase reserve volatility and duration. FNOL, notes, and medical data are siloed, NLP on adjuster notes is absent, and late severity signals create surprises.

What's holding you back

  • Poor NLP accuracy on unstructured notes

  • No clinician workflow integration

  • Ignoring false positives

  • Static models not retrained

  • Junior adjusters miss litigation signals

What success looks like

  • Claim duration decreases 20%

  • Litigation rate decreases

  • Paid-incurred ratio improves (approx. 15 %)

  • Closure rate increases

  • Catastrophic claims escalated immediately

How evolv helps

  • Applies NLP pipeline to adjuster notes and medical data surfacing litigation risk at intake

  • Embeds scoring in clinician workflows with clear escalation protocols and continuous retraining

  • Implements model governance ensuring explainability and falsepositive management

Why evolv?

Litigation prediction expertise for claims

Proven NLP and severity modeling frameworks

Transparent models supporting reserve accuracy

Experience reducing volatility and improving closure rates

Let's talk

Surface high-severity claims the moment they appear. Use NLP and unified claim data to detect litigation risk before costs escalate.