Tuesday, September 15th, 2026 — AI workflow orchestration could help workers’ compensation adjusters handle repetitive claim activity by identifying events that call for a response and initiating routine next steps. Representation letters, return-to-work notices, demand packages, missed follow-ups and periods without claimant contact can all trigger predictable actions. Language models make it possible to identify those triggers within the largely text-based information contained in claim files.
A phased approach would initially use AI to monitor files and alert adjusters to changes without taking action. The technology could later prepare recommended responses, such as draft acknowledgment letters, updated claim summaries, reserve-review tasks or wage statement requests. Adjuster corrections and approvals would provide a record of which recommendations can be trusted and where human review remains necessary.
Automation would come only after specific tasks establish a consistent track record. Lower-risk actions that adjusters routinely approve unchanged could eventually run without individual review, while decisions involving greater judgment or authority remain with the adjuster. The approach treats AI adoption as a progression from identifying claim activity to recommending responses and, where the results support it, automating selected parts of the workflow.
