Your lack of a safety program is job security for me.
My boss is very much like your boss. If there is not enough work for all of the adjusters, someone is going to get laid off. Fortunately for me (but unfortunately for your employees), you either do not have a safety program or you do not enforce it. Either way, I am guaranteed a lot of extra claims being assigned to our office and I will get my share of them. I know better than to criticize some of the dumb things employers do like not requiring hard hats on construction sites or removing safety guards from machinery. While I may think some of the employers we insure are morons for allowing accidents to happen, I will keep my mouth shut and enjoy the job security.
Burnout is a real problem.
This is really a stressful job. Not only am I under numerous time deadlines (the Best Practices guidelines we have impose time limits on almost every step of the claim), the phone is constantly ringing and often I cannot see over the stack of mail on my desk. I have to deal daily with people who are unhappy, whether it is the employer questioning a valid claim, an employee who wants to find a doctor with a better “bedside manner,” or the employee’s attorney threatening to file a motion for sanctions because the clerical department sent out an indemnity check a day late. When you have never-ending pressure from many different sources, the stress becomes a motivational killer. We have some real zombie adjusters due to job burnout. (WCxKit)
We have a revolving door.
While we have some career claims people in our office, the turnover rate is often 25% to 35% a year in some of the claim offices. There are several reasons adjusters are coming and going constantly. The pay is relatively low for the demands of the job. The claims office often hires adjuster trainees fresh out of college who after a few months or even a couple of years, realize this is not the right field for them. If I can make 10% more money somewhere else, I’m gone. If the office is understaffed (and most are), I have more files than I can handle. If my spouse gets a better job and wants to move to a new city, I’m happy to leave.
I never tell you my mistakes.
My loyalties are to my employer, not to the employers we insure. If I do an overall lousy job on your claims, I won’t tell you. Unless something really blows up bad, my boss won’t tell you either when I goof up. If I fail to contact the employee after the accident, and the employee gets an attorney (which will eventually run up the overall cost of the claim), I won’t tell you it is my fault. If I fail to investigate the claim and find out it is a fraudulent claim, while the employee will feel he got away with one, you as the employer will just have an uneasy feeling that something is not right, but we paid the claim anyway. (And yes, your premium will go up because I did not do my job).
I am overloaded.
If I work in a state that has few requirements for state form completion, if I am good at what I do, I can handle up to 150 work comp claims at a time. If I move to a state that has a different state mandated form to be completed for everything I do, 125 claims at anyone time is a heavy load. My boss in an effort to keep the cost of doing business down, will let my claim inventory drift up 175 or even 200 claims. There is no way I can properly handle that many claims, but I usually have no say in how many claims get dumped on my desk to handle. It is no wonder we have a revolving door and a lot of burned out adjusters.
My supervisor is really a nice person. When I work late, which is often as I am overloaded, the light is still on in my supervisor’s office. Ideally, depending on the experience level of the adjusters assigned to my supervisor, she would have four to six adjusters reporting to her. Like me, she is overloaded and often has eight to ten adjusters’ work product that she is responsible for, in addition to all her other office responsibilities. Instead of her reviewing my work, she has been assigned an inventory of claims to handle in addition to the supervisory duties. In an ideal world, she would check each of my claims every month, but in reality the norm is she will see my file the first month it is open and again when I am ready to settle the claim.
Don’t ask me for recommendations.
If you ask me for the name of a defense attorney, I will tell you the name of the defense attorney who takes over a claim from me and quietly does the investigation I failed to do. Or, I will tell you the name of the attorney who happens to be my golfing buddy (but I won’t mention that fact), or I will tell you the name of the attorney who throws the best Christmas party. If you ask for the name of a nurse case manager, and we don’t have our own, I will give you the name of the nurse case manager who showers the office with post-it notes, ink pens and calendars. If you ask for the name of a surveillance company, I will be glad to share the information on one that I know (as we often go out for drinks after work, but I won’t mention that fact).
Communication is a two way street.
Yes, our Best Practice guidelines require me to call you within 24 hours of the time the claim is reported to my office, and yes I am required to stay in touch with you throughout the course of the claim (but I seldom do). It is easier for me to forget about keeping the employer in the loop. If you are unconcerned about the employee or about the status of the claim, and never call me, it is easy for me to drop you from the information loop. If you don’t make any effort to get the employee back to work on modified duty – it’s your money – I will put the disability checks on automatic pilot and they will keep going out until you call me to tell me the employee is back to work (which you may forget to do as we have not been communicating throughout the course of the claim).
You make my life miserable.
Between your lack of a safety program and your lack of a return to work program, you create a lot of unnecessary work for me. When you fail to report the claim timely, you alienate the employee and whether or not the employee gets an attorney, your failure to report the claim on time creates a lot of extra phone calls, and makes the claim cost more to resolve. When you have no drug testing policy, no fraud prevention policy, no medical management program and no organized approach to handling claims, I bear the brunt of your mistakes.
I’m happy to let someone else do it.
Since I am overloaded with work to do, I have no qualms about letting the nurse case manager do all the contacts with all the medical providers. I have no qualms about letting the defense attorney do the investigation I never had time to get around to doing. When my mistakes and goof ups do come to light, I have no qualms about letting the broker deal with your irritation. It is not because I do not want to do a good job, I’m just have too much to deal with – see all of the above things I won’t tell you.
This is a tongue in cheek parody; please take it with a grain of salt.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. www.LowerWC.com Contact: RShafer@ReduceYourWorkersComp.com
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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.
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