Scaling Workers Comp Oversight with CLARA
If you’ve ever tried to oversee a TPA with standard dashboards, you know the frustration: the report looks complete, but the reality feels unfinished.
For a large, self-insured North American retailer, that gap created constant pressure to move faster without sacrificing judgment, especially when determining which workers comp claims required urgent attention and which could wait.
In internal discussions, the same themes kept resurfacing:
“We need to know which claims are most high-risk, so we can focus reserve and settlement review meetings where it counts.”
So, they brought in CLARA to close the oversight gap.
Background
A large North American consumer goods retailer operates a self-insured workers’ compensation program at a significant scale. With more than $20 billion in annual revenue, the organization manages a high volume of claims across its operations throughout North America.
The company maintains a lean internal risk function while relying on external partners to support day-to-day claims handling. Oversight of the program is centralized, placing broad responsibility on a single Risk Manager to monitor claim activity, engage with TPA partners, and ensure reserving, settlements, and injured-worker care remain aligned with program standards.
As claim volume and complexity increased, maintaining consistent oversight across the program became a growing focus for the risk function.
The Challenge
The client’s Risk Manager faced the impossible task of overseeing a complex workers’ compensation program as a “one-person army.” With limited bandwidth, team members in that role struggled to consistently identify high-severity claims that required urgent reserve and settlement reviews, making prioritization a daily challenge.
Beyond the need for extreme efficiency, the Risk Manager required a reliable second set of eyes to gain clearer visibility into TPA performance and ensure partners remained proactive as claims evolved, rather than reactive after issues escalated.
The goal was to find a solution that could seamlessly integrate with and augment the existing core claims system environment, delivering the deep intelligence needed to pinpoint the most dangerous claims and, ultimately, support the highest standard of care for injured workers.
The CLARA Solution
To address the client’s challenge, CLARA provides a specialized intelligence layer designed to empower self-insured Risk Managers. By shifting the focus from manual oversight to a more proactive, data-driven approach, CLARA supports a more effective way to manage TPA partnerships and employee care.
CLARA serves as the essential second set of eyes, allowing a single Risk Manager to scale expertise across thousands of claims.
By integrating directly with Origami Risk, CLARA does not simply add more data. It adds meaning and context to existing claim information. This approach helps close the oversight gap by moving beyond traditional reliance on TPA reporting and enabling the Risk Manager to hold partners accountable through objective intelligence embedded within the existing claims environment.
How CLARA Strengthened Oversight and Care
| Proactive Risk Mitigation & Reserving Strategy CLARA’s intelligence capabilities help surface high-severity triggers and potential litigation earlier, supporting more focused reserving and intervention before escalation occurs. This approach enables more precise capital allocation and helps reduce disruptive reserve volatility within self-insured programs. | Modern TPA Accountability & Empowerment Traditional TPA oversight is often reactive and manual. CLARA introduces greater transparency into TPA execution, allowing the Risk Manager to move beyond file audits and toward more collaborative, results-focused discussions grounded in shared visibility. | The Human-Centric “Better Care” Approach A workers compensation claim represents more than a file. It represents an employee’s recovery journey. CLARA supports earlier identification of appropriate care paths, helping ensure injured workers receive the right treatment sooner and experience smoother, faster recoveries. |
The Outcome
With CLARA in place, the Risk Manager gained the clarity and support needed to operate more proactively across a complex workers compensation program.
High-severity claims could be identified earlier, reserve and settlement discussions became more focused, and oversight of TPA partners shifted from manual validation to more strategic, outcome-driven collaboration.
The organization also improved its ability to support injured workers through earlier intervention and more consistent care decisions. This approach enabled a more confident and scalable model for workers compensation oversight that balanced operational efficiency, financial discipline, and employee care within the existing claims environment.
Surface Meaningful Insight from Claims Data with CLARA
The most important signals in a workers compensation program are often hidden in plain sight. CLARA helps self-insured organizations surface meaningful insight from everyday claims data, supporting better prioritization, stronger oversight, and better outcomes for injured workers.
Request a demo to see how CLARA strengthens oversight and supports more confident claims decisions.
