• Menu
  • Skip to main content
  • Skip to secondary navigation
  • Skip to primary sidebar
  • Skip to footer

Before Header

  • About
  • Contact
  • Privacy
 
Allan Koba

Amaxx Workers Comp Blog

Reduce Workers Compensation Costs By 20-50%

Header Right

  • Home
    • Training Center
  • Search
    • Free Resources & Solutions
    • Subscribe to Free Newsletter
    • Create Free Training Center Account
    • Enroll in On-Demand Courses
    • Activate WC Mastery Membership
    • Request Strategic Coaching Session
    • Buy WC Guidebooks
  • Membership
    • Insider (free account)
    • WC Mastery
    • Teams & Managers Mastery
    • Training Partners
  • Products
    • On-Demand Courses
    • Specialty Courses
    • Certifications & Mastery Courses
    • Ultimate Guidebooks
    • Coaching
  • Blog
    • Video Blogs
    • COVID-19 / Coronavirus Pandemic
  • Login

Mobile Menu

  • Home
    • Training Center
  • Search
    • Free Resources & Solutions
    • Subscribe to Free Newsletter
    • Create Free Training Center Account
    • Enroll in On-Demand Courses
    • Activate WC Mastery Membership
    • Request Strategic Coaching Session
    • Buy WC Guidebooks
  • Membership
    • Insider (free account)
    • WC Mastery
    • Teams & Managers Mastery
    • Training Partners
  • Products
    • On-Demand Courses
    • Specialty Courses
    • Certifications & Mastery Courses
    • Ultimate Guidebooks
    • Coaching
  • Blog
    • Video Blogs
    • COVID-19 / Coronavirus Pandemic
  • Login
  • About
  • Contact
  • Privacy
You are here: Home / Claims Resolution and Settlement / Settling WC Claims / A Day in the Life of a Busy Workers Compensation Insurance Adjuster

A Day in the Life of a Busy Workers Compensation Insurance Adjuster

July 26, 2010 By //  by Rebecca Shafer, J.D. Leave a Comment

If you have ever wondered what your workers comp adjuster does in a day, please read this fictional, but true-to-life account of an adjuster’s typical day. Let’s take a look at what a typical adjuster does during the day and reflect on how we can help him/her help us better manager our programs. Although this blog refers to workers compensation adjusters, the work day of others is probably about the same. One noted exception is a “field adjuster” who may work on the road, for example, in auto claims.

Most adjusters who have been on the job for a realize their workload will always be greater than they can ever attend to properly. This won’t stop most of them from trying to cover everything that needs to be done. It is not unusual for the dedicated adjuster to arrive at the claims office early and be one of the last employees to leave at night.

Click Link to Access Free PDF Download

“8 ‘Think Outside the Box’ Tactics to Settle Workers’ Comp Claims”


It is usually the workers comp adjuster who arrives first at the office and makes a pot of coffee for herself (or himself) and her co-workers. After a few sips of coffee, the adjuster turns on her computer and brings up her diary (her computer calendar) of all the claims she needs to work on during this day. However, before she starts to work on any of her claims, she turns to the telephone and retrieves all her voice mails from claimants (employees), employers, medical providers, attorneys, nurse case managers, her supervisor, various vendors and others who have called her about her claims.

The adjuster than compares her voice mail messages with her diary to see where she can combine the diary and voice mail to save time on the files. After she combines the diary and the voice mails, she prioritizes the claims and creates her work agenda in the order of importance.

During her workday, the workers comp adjuster has frequent and sometimes complex contacts with many parties. For the next couple of hours the adjuster will be on the telephone contacting employers, employees and medical providers to obtain additional information about the progress or status of the claims.

If the adjuster is good at multitasking, she will be entering file notes on each claim as she is talking to each person. If she is not comfortable with multitasking, she will write up her files notes immediately following each phone call and before she starts the next phone call.

By the time the adjuster is done with her phone calls for the morning, the daily mail should have arrived at her desk (or have been scanned into the computer system). The adjuster then turns to reviewing each item of correspondence and entering her file notes on each medical report, attorney’s letter, etc.

The adjuster never get through her morning phone calls that she makes and the daily mail without receiving additional phone calls from people. Depending on the claim office philosophy or the adjuster’s preference, the adjuster will stop working on the incoming mail and take the phone calls as they arrive, or allow them to start accumulating again in her voice mail.

It is an old claims office adage – “Your interruptions will get interrupted.” The adjuster must decide for herself if she is more proficient by taking each phone call as it arrives, or by grouping them and returning the phone calls once in the morning and once in the afternoon.

Between telephone calls and correspondence, the adjuster’s morning is packed with other things to do.

If the supervisor has assigned a new workers comp claim to her, she must put on hold all the items on her agenda and make her three-point contacts with the employer, employee and medical provider. If she has a worker’s comp board hearing, she may have to leave everything and attend the hearing. If she has a settlement conference, she may attend the settlement conference in person, or by telephone. If she has a crisis of some type on any of her files, she will stop work on her daily agenda and deal with the crisis. Our third party-administrators and insurance companies have many adjusters who are the primary contact for many of us in the workers’ compensation field.

After a quick lunch, often eaten at her desk in order to save time, the workers comp adjuster starts her afternoon round of phone calls, mail review, outgoing correspondence and file reviews. In the middle of all these activities, the adjuster will often take time out to discuss complicate claim issues with other adjusters or to provide mentoring to inexperienced adjusters. Over the cubicle wall discussions of claims and procedures will occur throughout the afternoon as she assists other adjusters with their claims.

Every day the adjuster is interpreting and applying the workers comp statutes, the insurance policy coverage and her employer’s work policies and procedures. The exercising of judgment and initiatives is a routine part of the adjuster’s daily task. The adjuster not only makes many decisions during the day, but also has to communicate effectively those decisions both verbally and in written communications.

FREE DOWNLOAD: “8 ‘Think Outside the Box’ Tactics to Settle Workers’ Comp Claims”

In the states with complicated state forms to file on every claim, the adjuster will often set aside a specific time each day to be sure the state mandated forms are completed and filed either electronically or by mail as required within her state.

By the time the adjuster turns out the office lights at night, she will have had an impact on the lives of several claimants as she has assisted them in obtaining the medical and indemnity benefits they are owed. She will have also had an impact on the insurer as she has provided the benefits the employee is entitled to while protecting the assets of the insurer from being overspent. It’s not easy being a workers comp adjuster but it is often a satisfying and fulfilling job.

Author Rebecca Shafer, J.D., Consultant, President, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact: Info@ReduceYourWorkersComp.com or 860-553-6604.

WC Round Table LinkedIn: http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

WC Calculator: http://www.LowerWC.com/calculator.php

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers’ comp issues.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

FREE DOWNLOAD: “8 ‘Think Outside the Box’ Tactics to Settle Workers’ Comp Claims”

Filed Under: Settling WC Claims Tagged With: Meet the Adjuster

Related Articles

Tighten Up Your Settlement Agreements

Tighten Up Your Settlement Agreements

4 Steps to Reduce Exposure of Vacated Settlement Agreement

4 Steps to Reduce Exposure of Vacated Settlement Agreement

A User Guide to Resolving Liens in Work Comp Cases

A User Guide to Resolving Liens in Work Comp Cases

Medicare Secondary Payer: What to Expect in the Coming Months (and 2022)

Medicare Secondary Payer: What to Expect in the Coming Months (and 2022)

Know Why You MUST Retain Settlement Authority and How Much You Need

Know Why You MUST Retain Settlement Authority and How Much You Need

Tips for a Successful Workers’ Comp Mediation

Tips for a Successful Workers’ Comp Mediation
settlement consultant

4 Steps to Settle More Workers’ Compensation Cases

4 Steps to Settle More Workers’ Compensation Cases

Tactics to AVOID When Settling Workers’ Compensation Claims

Tactics to AVOID When Settling Workers’ Compensation Claims

6 Tips for Successful Mediations by a Claim Handler

6 Tips for Successful Mediations by a Claim Handler

The Clear Indicator To Start Working on Settling a Workers’ Comp Claim

The Clear Indicator To Start Working on Settling a Workers’ Comp Claim

Mediation to Successfully Settle Workers’ Comp Claims

Mediation to Successfully Settle Workers’ Comp Claims

The Work Comp Tool Box: Employing Creative Strategies to Settle Cases

The Work Comp Tool Box: Employing Creative Strategies to Settle Cases

Free Download

8 'Think Outside The Box' Tactics To Settle Workers' Comp Claims - FREE Download Click Here Now!

Train to Succeed

BECOME CERTIFIED IN WORKERS’ COMPENSATION

Proven Course Catalog & WC Toolbox Give You The Power To Achieve Lower Costs and Better Injured Worker Outcomes

VISIT WORKERS' COMP TRAINING CENTER

Previous Post: « Louisiana Workers Comp Rates to Drop More Than 4 Percent
Next Post: Retaliatory Discharge Borrowed Employees Are Protected As Well »

Reader Interactions

Leave a Reply

Your email address will not be published. Required fields are marked *

Primary Sidebar

FREE DOWNLOAD

8 'Think Outside The Box' Tactics To Settle Workers' Comp Claims - FREE Download Click Here Now!

Our Sponsors

MSAs, Section 111 Audits, & Conditional Payment Resolutions
 

Post-Settlement Administration
 

ARCADIA - Enhancing Settlement Outcomes

The Structured Settlements Company
 

Catastrophic and Risk Solutions, Case Management Solutions, and Specialty Networks
 

Medcor

Injury Triage, Onsite Clinics

Read Our Award-Winning Blog

Blog Categories

Search Our Archive

Subscribe to Our FREE Newsletter

Return-to-Work Essentials

Footer

Search Our Archive

Search our continually growing archive of over 2500 articles about Workers' Comp issues.

Quiclinks

  • Calculators
  • Terms & Abbreviations
  • Glossary of WC Premium Terms
  • WC Resources
  • Best Practices
  • Industries
  • Return-to-Work Essentials

RSS Recent Blog Posts

  • Properly Handling Mental Claims in Workers’ Compensation
  • Adjuster Communication Is Critical When Denying Claim
  • Utilize Different Return To Work Approach For Different Employees
SUBSCRIBE TO OUR FEE NEWSLETTER
Let Us Help You Stomp Down the High Cost of Workers' Comp!
Top of Page ↑
  • Home
  • Training Center
  • Search
  • Membership
  • Products
  • Blog
  • About
  • Contact
  • Subscribe
  • Login
Copyright © 2023 Amaxx, LLC. All Rights Reserved. · Privacy Policy / Legal Notice