Slash Workers’ Comp Claims Processing Costs with AI Automation

The first 24 hours after a workplace injury are the most critical. Yet for most carriers, this period is defined by a slow, manual process that delays claim registration by an average of 7-14 days. This initial bottleneck is more than just an inconvenience; it’s a massive financial drain. Inefficient manual processing adds an average of $2.3K in administrative costs to every single claim. When the National Safety Council reports that the average cost of a medically consulted injury is already tens of thousands of dollars, an extra $2,300 in pure administrative waste is unacceptable.

These delays and costs stem from a broken intake process. With initial claim submission error rates hitting 40% , skilled claims teams are forced to spend 60-70% of their time on low-value administrative work instead of managing claims. This hurts the carrier’s bottom line and, most importantly, delays an injured employee’s access to care.

The Anatomy of a Broken Process

The traditional journey for a workers’ compensation claim is a chain of manual handoffs and reviews.

1. FROI Submission: An employee or employer manually fills out a First Report of Injury (FROI), often with missing or incorrect information.
2. Medical Report Collection: Healthcare providers submit a First Medical Report through various channels, creating a disorganized influx of documents.
3. Manual Validation: Intake staff manually review the compiled documents, trying to connect the FROI to the right medical report and policy.
4. Coverage Verification: An adjuster or underwriter spends significant time checking each document against policy systems to confirm coverage.
5. Final Registration: Only after all manual checks are complete is the claim finally entered into the core claims management system for assignment.

Each step is a potential point of failure, introducing errors and delays that prevent the claim from reaching the right handler quickly.

Intelligent Automation for the First Report of Injury

Kognitos transforms this inefficient workflow by automating the entire process, turning days of work into minutes. It’s a seamless, three-step journey powered by agentic AI.

• Digital Intake: Kognitos automatically captures FROI forms and medical reports as they arrive, instantly digitizing them for processing. There is no manual data entry.
• AI Validation: Intelligent algorithms perform completeness checks and verify coverage eligibility in real-time. The system understands the information within the documents, ensuring accuracy from the start.
• Auto-Registration: Once validated, the claim is automatically registered in your existing claims management system and assigned to the appropriate handler based on your business rules.

This direct connection to your core systems ensures a smooth, error-free flow of information, eliminating the manual bottlenecks that cause backlogs.

A Better Outcome for Everyone

Automating the claims intake process creates a powerful positive impact across the board.

For the Injured Employee: The most significant benefit is speed. Faster claim registration leads to quicker confirmation of benefits and faster access to necessary medical care. This reduces the stress and uncertainty for an employee during a difficult time, creating a vastly improved and more compassionate experience.

For the Carrier: The operational and financial benefits are transformative. By eliminating the $2.3K in excess costs per claim and cutting the 40% error rate, the return on investment is immediate. More importantly, it frees your skilled claims handlers from administrative burdens. Instead of chasing paperwork, they can focus on strategic claim management, helping employees with return-to-work plans, and mitigating complex claim escalations. This boosts efficiency, improves outcomes, and increases employee satisfaction.