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Workers’ Compensation Claims Solutions

Data-driven insights to improve workers’ comp claims

Complex claims and compliance costs insurers

Workers’ compensation insurers are challenged with managing complex claims, rising claim severity, and stringent reporting obligations. And with many experienced claims handlers nearing retirement, the challenges become even more daunting.

Powerful analytics help conquer claims challenges

Verisk’s data-driven claims solutions empower workers’ comp insurers to mitigate risk, contain costs, streamline claims processing, verify appropriate medical treatment, and enable accurate compliance reporting.

Slash time and spend on record review

Discovery Navigator Calculator

Slash time and spend on record review

Discover how much time and money your claims organization can save by trying our virtual Savings Calculator Now.

Lighting the path to better workers’ comp outcomes

Lighting The Path To Better Outcomes Thumbnail

Discover how workers’ compensation data can provide valuable insights through advanced automation technology for improved results.

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Identify severity faster with predictive analytics

Detecting claim severity early can help you improve triage, contain costs, and enhance employee return-to-work timelines. Our solution leverages predictive analytics to accurately identify workers’ comp claim severity as early as day one.

  • Scores and re-scores claims daily as new information is received
  • Integrates prescription and medical data directly from your PBM and MBR providers
  • Accurately predicts 88 percent of high severity claims within first 30 days
Learn about wcNavigator
Speed Precision

Speed and precision at claim intake and investigation

Streamline claims processing and improve SIU referrals with powerful tools that leverage robust industry data and analytics to deliver critical insights early in the life of a claim.

Learn about ClaimSearch

Discover the latest workers’ comp claims insights

Wcsma Version Release

CMS releases the WCMSA Reference Guide Version 3.9

CMS has made various updates to different aspects of its WCMSA process, including removing the time limit on Amended Reviews.

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Harnessing Ai Teaser

Harnessing AI and ML through Discovery Navigator to save time and money on medical records review

Harnessing AI and ML through Discovery Navigator to save time and money on medical records review

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Cms Medicare Teaser

CMS releases updated Workers’ Compensation Medicare Set-Aside Reference Guide (Version 3.8) – changes impact CMS’s WCMSA re-review process

The Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.8)

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Blog Teaser9

COVID-19 and Workers’ Compensation in 2022: The Great Resignation and Closing the Talent Gap

We continue our look at how the COVID-19 pandemic continues to impact workers’ compensation.

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Detect fraud in workers’ comp claims

Detect Fraud

Detect fraud in workers’ comp claims

Workers’ comp fraud is one of the fastest-growing types of insurance fraud. Fight it with our extensive suite of claims fraud solutions that leverages robust data and innovative technology.

  • Predictive analytics fueled by more than 1.5 billion claims
  • Medical provider fraud analytics that score more than 1.5 million providers
  • Advanced link analysis software that uncovers organized fraud activity

Streamline data reporting, improve compliance

Accurate, on-time compliance reporting


Accurate, on-time compliance reporting

Data accuracy and timely reporting are critical to EDI compliance, but varying reporting requirements make compliance challenging. Our leading solutions help you save time and improve workers’ comp reporting accuracy and timeliness.

  • Meet data collection organizer (DCO) requirements for aggregation and valuation of policy and claim data for the submission of unit statistical reports (USRs)
  • Consolidates medical bills into one data warehouse to manage compliance reporting for all DCOs
  • Meets requirements for aggregation and valuation of indemnity claim data for the submission of the indemnity data call to the DCOs

States: Capture workers’ comp data efficiently


States: Capture workers’ comp data efficiently

States seeking to initiate EDI reporting or transition to a new IAIABC release can get precise, cost-effective data intake for workers’ compensation claims and medical data through wcCapture™.

  • Helps collect FROI and SROI from insurers with greater efficiency
  • Gathers medical data needed to set fee schedules, identify fraud, and implement cost containment strategies

Actionable insights, better outcomes

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Actionable insights, better outcomes

Learn how workers’ comp analytics helped improve EDI compliance at Liberty Mutual and for the Commonwealth of Virginia.

Achieve full Medicare compliance, reduce exposure

Medicare Compliance

Achieve full Medicare compliance, reduce exposure

Whether you need to quickly and accurately identify and report Medicare recipients, dispute conditional payment liens, or allocate future medical costs, our solutions and services help you comply with CMS and avoid costly penalties by providing you with key information to:

  • Satisfy Section 111 reporting requirements
  • Automatically fulfill MRN reporting obligations
  • Reduce conditional payments
  • Determine accurate workers’ comp Medicare Set-Asides

Verisk also provides additional claims reporting compliance solutions

Child Support Icon Child support intercept matching
Casualty Reporting Casualty reporting
Questionable Claims Questionable claims reporting
Ofac OFAC screening

Optimize claims resolution

Close complex claims faster

Medicare Future Allocations

Close complex claims faster

Open claims costing your organization? Our team of medical and legal professionals can remove obstacles to closing claims with fast settlement approvals.

  • Coordinated settlement conferences for large-scale claims resolution
  • Expedited Medicare Set-Asides or conditional payments preparation

Automate the retrieval of medical information

Leverage Ai With Discovery Navigator

Automate the retrieval of medical information

A cutting-edge that tool utilizes natural language processing (NLP) and offers options for identifying and extracting certain terms within unstructured medical records resulting in expedited file review at a far lower cost than manual review.

Facilitate fast and fair claims resolution

Liability Navigator

Facilitate fast and fair claims resolution

Improve settlement decisions and negotiation strategies with a claim-matching solution that analyzes a claim’s attributes against your company’s historical data and provides guidance on settlement amounts and likely length of time to settle.

Contact Us to Learn More

Other Ways to Connect

We are available Monday through Friday, 7 a.m. — 9 p.m. US Eastern Time:

  • Chat Now

    Note that password resets and user information are not available through Live Chat or Email. Instead, please call the main toll-free number below.

  • Main Toll-Free: 1-800-888-4476

  • Global Toll-Free: International Access code, then 800 48977489
    When calling from the UK, please dial 00 800 4897 7489

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