One of the most important parts of the claims process is getting the supervisor to report the claim. Once reported, the claim can take the next step to getting to the carrier and the adjuster.
This is a process and breakdown in the links of communication lead to failure. Trust me—failure happens all of the time in business and insurance. This is one item that puts employers and carriers behind the proverbial 8-ball because a delay in reporting is almost guaranteed to drive up the cost of the claim. It can also severely limit your options for claim defense and leads to penalties, leakage, and errors.
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Links of Communication Fail With The Supervisor
The links of communication fail, and from my experience they fail at that very first level—the supervisor on the floor. This supervisor is the one that gets the ball rolling. They are the ones readily available to look at failed machines, leaking oil that caused injury, or perhaps some other malfunction.
However, the supervisor often doesn’t take their position in dealing with injury claims seriously. He fails to talk to the injured worker for more than 2 minutes to make sure he/she is Ok and then moves on to the next task. All of that opportunity for immediate claims investigation is now lost. Those initial moments are crucial to the claim investigation. What did the employee say that injured him? Did they see something wrong before they were hurt? What caused the injury? Were there any witnesses? Who helped you up? Who were you working with before you got hurt? The list of questions goes on forever.
It is important to make this process as simple as possible for the supervisor to execute. Delays in reporting, as well as proper injury investigation are so important; it is our recommendation that you give your supervisors support to complete these tasks. The simplest way to accomplish this is to work with qualified professionals on injury reporting and on-site investigation.
Immediately Report Claim and Get Employee Medical Attention With Injury Triage
If the injured employee’s injury does not create an emergency situation, the supervisor should direct the injured employee to call a toll free, 24 hour/7 day nurse access number. The information about the injury obtained by the RN at the time of the initial report is more accurate and complete than when the medical information is obtained second-hand from the employee’s supervisor. Plus, the triage nurse will evaluate the medical needs of the injured employee and recommend the appropriate level of care, whether it is a walk-in clinic, first aid on the job site, providing home-care instructions, or an emergency care facility. Costly emergency room visits and medical clinic visits are avoided when they are not needed.
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On-Site Investigation From SIU Provider
The second area that is critically important to improve is the post injury investigation. Once notified of the injury, the supervisor will contact the SIU provider who will offer on-site investigation with little or no notice. Skilled investigators will be deployed to the scene to obtain photos, interview the injured worker and witnesses, diagram where and how the accident occurred, or create a video reenactment. This imperative information is captured to understand the incident and create a plan to properly manage the claim.
Lack of reporting, and lack of discipline, is where a lot of employers are failing their own safety programs. The task of being a supervisor and a “first-responder” is an important one. Help your best workers perform their best work by giving them the tools of skilled professionals to get the job done right. If you need a recommendation for qualified service providers, please contact us.
Author Michael B. Stack, CPA, Principal, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.
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