Simple Steps for Better Claim Outcomes

I’ve been thinking a lot lately about how we improve outcomes in Workers’ Compensation. For those of us in the industry, claims advocacy is important in influencing better outcomes and less litigation. We aren’t there yet – insurers, TPAs, and employers all need to continue to strive for better communication with injured workers. We need to teach our clients and insured’s that how they treat injured workers affects the claim. There are four simple things we need to do as claims professionals to influence better outcomes:

·        Practice the “Golden Rule” - Do to others what you want them to do to you.

It sounds simple, but be nice. You’re dealing with someone who is injured. They’re not at their best. Show some empathy. If you had a claim how would you like to be treated? What if it was your family member?  

·        Answer the phone – Pet peeve alert. How often do you call someone and always get their voicemail? I know claims professionals spend a lot of time on the phone, but answering quickly and returning calls promptly are important. If you aren’t otherwise engaged in a phone call, you should answer your phone.

·        Respond to e-mails timely – Most claims organizations have responsiveness standards that dictate how quickly e-mails should be answered. If you can’t answer the question or need to do some research, respond with that information so that the sender doesn’t feel ignored.

·        Educate – We love jargon and acronyms in claims. We use lots of terms that aren’t known by the general public and the claims process is foreign to most. At the beginning of the claim, take the time to educate the injured worker on the process. For adults in the US, the average reading level is that of a 7th or 8th grader. Make sure to explain terms in ways that an “average” reader or listener can easily understand