Current economic conditions are having an effect on the entire insurance industry. Claims are going up. Not just workers’ comp claims, but all claims, including both valid and invalid or fraudulent claims. Suspected fraudulent claims related to workers’ compensation insurance were up 71%. Some employees are filing claims after or pending employer layoffs not filed at the time of the injury.
These are often valid claims but were not filed perhaps because the employee was worried about the effect it would have on their employer, or they would rather be working than recuperating while receiving workers’ comp benefits. On the other hand, once an employee is laid off, workers’ comp benefits are better than unemployment benefits or no income at all.
Adjusters have a higher number of cases because of downsizing by insurance companies. Not only do adjusters have heavier caseloads, but 40% of their time is spent on administrative duties unrelated to the business of helping move cases toward closure; admin duties required by workers’ comp regulations.
In a recent interview, John A. Mastropietro, Chairman State of Connecticut Workers’ Compensation Commission said, “Insurance companies have downsized in recent years enormously, thereby leaving fewer claims adjusters, who are now handling a greater volume of cases. So there’s a tendency to not move on the part of those making decisions.”
Cases are taking longer because the insurers are trying to cut costs wherever possible, and are therefore taking a harder look at their workers’ comp claims. This also slows down the process, because cases that would just move along are being fought on both sides. More claimants and a more rigorous review process instituted by insurers means more work per case with fewer adjusters to do the work.
Lastly, the economy is causing the extension of cases due to the perception that no jobs are available. Often labor market surveys are conducted showing there are no jobs available for the injured worker or claimant. So, an expensive and previously useful tool available to the case managers and claims adjusters backfires.
It is true jobs are more difficult to come by. Companies are cutting their human resource departments and their advertising budgets, including “open position” advertising.
Another reason human resource departments are not advertising is due to the overwhelming size of the applicant pool. Any job posted online from executive to laborer is bound to receive hundreds if not thousands of applicants. This creates a situation very similar to the adjuster’s — more work for less staff — or “Paralysis through Analysis.” (workersxzcompxzkit)
Too much paperwork and forms for each applicant results in a continuous delay in filling the position. Therefore, many human resource managers are looking for alternative ways to locate the proper fit for their open positions. Personal relationships and peer or other ‘networks’ are often the key to landing an appropriate position in any field.
Information provided by Katrina Paglierani of National Job Finders. www.nationaljobfinders.com/welcome
Author: Rebecca Shafer, J.D. consults for mid-market and national accounts focusing on project management, risk management assessments, data review, benchmarking, and development of Workers’ Compensation and Injury Management Programs. Projects focus on development of training and education programs, document design, evaluation and integration of insurance claims administration and TPA services. Contact her at: [email protected]
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