How to use claims analytics to predict future people risk

Broadstone’s Sharon Harwood-Davis looks at why employers need to move from claims reporting to people risk forecasting.

For many years, employee benefits claims analysis served a relatively straightforward purpose. We looked backwards.

Claims data helped employers understand how benefits were being used, assess insurer performance and inform renewal discussions. It provided a useful snapshot of what had happened and what costs might look like in the year ahead.

That remains important. But the environment employers operate in today is far more complex. Rising healthcare costs, changing workforce demographics, growing demand for mental health support and increasing pressure on productivity have elevated workforce health from an employee benefits issue to a broader business concern.

Against that backdrop, a question I am hearing more frequently is not simply "What happened?" but "What might happen next?" The answer may already exist within the data you collect today.

Look beyond benefits in isolation

One of the most common challenges I encounter as an employee benefits adviser is that benefits and workforce data are often reviewed independently of each other.

Private medical insurance (PMI) claims might sit in one report. Employee assistance programme (EAP) usage in another. Occupational health referrals, Group income protection (GIP) claims and wellbeing platform engagement somewhere else entirely. Yet people risk rarely follows those same boundaries.

An employee experiencing stress, for example, may access an EAP, visit a GP, require occupational health support and potentially take time away from work. Examining only one element of that journey can limit the insights available.

When different data sets are viewed together, a much richer picture begins to emerge. Employers can start to identify:

Areas of growing health risk
Emerging workforce trends
Potential risk hotspots within employee populations
Opportunities for early intervention
The likely impact on productivity and absence

This is where the conversation shifts from benefits management to workforce strategy.

Why historical reporting is not enough

One of the biggest changes I have seen in recent years is employers becoming far more interested in what their data might reveal about future workforce challenges than what it says about the previous policy year.

The questions have become more strategic:

Which health conditions are becoming more prevalent across our workforce?
Which employee populations appear most vulnerable?
What trends could affect productivity over the next three to five years?
Are there early indicators of future absence challenges?
Which wellbeing interventions are making the greatest difference?
How should future benefits investment be prioritised?

These are not solely benefits questions. They are business questions. The value lies not in producing more reports. It lies in identifying patterns and understanding what those patterns may be telling us about the future.

Context matters as much as the data itself

Interpreting workforce data accurately requires context. Not every employee has access to every benefit, and many organisations operate different levels of provision across their workforce.

Senior leaders may have access to comprehensive healthcare benefits, while other employee groups may rely more heavily on health cash plans, wellbeing services or Occupational Health support.

This can significantly influence the picture that emerges from the data.

Focusing exclusively on one benefit may only reflect the experiences of part of the workforce, potentially leading to an incomplete picture of risk.

In my experience, understanding who has access to support is just as important as understanding who is using it.

Looking for signals, not just statistics

One of the most valuable aspects of integrated data analysis is the ability to identify trends before they become significant business challenges.

In isolation, an increase in EAP usage may not appear noteworthy. Nor might a rise in occupational health referrals or an increase in mental health consultations through private medical insurance.

However, when these trends begin appearing across multiple data sources, they can signal a much broader workforce issue. The objective is not simply to monitor activity. It is to understand the direction of travel.

The earlier you can identify emerging risks, the greater the opportunity to intervene and potentially improve outcomes for both your employees and your organisation.

The untapped value of GIP

Group income protection remains one of the most underutilised sources of workforce insight.

While it is often viewed primarily as a protection benefit, I believe it can provide valuable insight into the health conditions most likely to result in prolonged absence and workforce disruption.

When analysed alongside healthcare claims, occupational health activity and sickness absence data, it can help you understand:

Which conditions have the greatest impact on workforce capacity
Where recovery periods may be extending
The effectiveness of rehabilitation and return-to-work support
Opportunities for earlier intervention
Potential future workforce resilience challenges

Viewed in this way, GIP data becomes much more than a claims record. It becomes an indicator of future workforce resilience.

Why engagement matters as much as claims

Some of the most interesting insights come not from what employees are doing, but from what they are not doing. Low engagement with benefits can sometimes be just as revealing as high levels of claims activity.

Questions worth asking include:

Are employees accessing preventative healthcare services?
Are at-risk groups engaging with available support?
Are mental health resources being used effectively?
Are some employee populations consistently underutilising benefits?

Low engagement may indicate awareness issues, accessibility challenges or wider cultural barriers.

Whatever the reason, understanding engagement patterns can help you build a more complete picture of future workforce risk.

A new role for workforce data

For many years, workforce health data was primarily used to explain what has happened. Today, the opportunity is very different and is becoming an increasingly important part of employee benefits strategy.

Employers have access to more health, wellbeing, absence and utilisation data than ever before. The challenge is no longer collecting information. It’s connecting the dots, identifying emerging risks and understanding what those insights may reveal before challenges begin to affect workforce performance.

The organisations gaining the greatest value are not simply measuring activity. They are using data to anticipate challenges, prioritise investment and make more informed decisions.

As employee benefits advisers, we have an opportunity to help employers unlock greater strategic value from the data your programmes generate. Not by focusing solely on who made a claim, but by understanding what those claims may be telling us about the future.

Understanding your future people risk starts with understanding the story your workforce data is telling you.