Healthesystems: Complex claims in workers’ compensation are defined by two primary factors – cost and duration – exceeding those of typical claims. The prevailing consensus among industry leaders is that the incidence of complex claims is increasing, and over 50% of surveyed stakeholders think that complex claims are a major challenge for the industry.

The factors that can lead to claim complexity are multiple, intricate, and often overlapping. Some are more likely than others to cause complexity. Depending on the claim, factors associated with and/or contributing to high-cost claims may be unavoidable. But understanding which factors influence the course of a claim is key to identifying and mitigating risk.

Read the full article here.  It draws on several WCRI studies, including Factors Associated with High-Cost Claims.