Review Your Claim Management Systems

A new year means an opportunity to review your claim management processes to ensure best practices are followed. The result of a “new year review” can mean increased claim handling efficiency and reduced workers’ compensation costs. It can also improve relationships with existing clients and allow others to notice what is being done to by industry leaders. Now is the time to review your claim management process.

Review Your Injury Reporting Platform

The timely reporting of a work injury saves money. While many variables a claim management team cannot control, they can ensure a platform is available to interested stakeholders to accurately and timely work on all work injuries. Common barriers include:

• Paper driven systems that are outdated, cumbersome, and prone to incomplete or inconsistent information;

• Telephonic systems rely on someone to leave a message. Incomplete information is a common downfall with this system; or

• Employer representatives who are unwilling to assist or provide injured employees with injury reporting information.

All interested stakeholders should strive to have an injury reporting system that utilizes current technology. This is often found in the form of web or app-based technology. This allows for immediate access to injury reporting systems. It also allows users to preserve evidence by taking pictures from a smartphone and uploading the image to the claim management system. It can also ensure complete and accurate injury information is captured.

Emphasize Safety

Safety standards and training are drivers in workers’ compensation costs. Claim management teams can be an important player when it comes to workplace safety. Effective claim managing teams can help improve safety by providing the following to employers, and other stakeholders:

• Send monthly reminders that include tips for a safe workplace. This can include reminders to replenish first aid kits, perform safety checks in the workplace environment, and information on how to avoid injuries.

• Provide information on effective safety training. Many employers are not equipped to provide effective safety training to their employees. This is because they often lack the workforce to provide effective training materials. Proactive claim management teams can prepare general safety information and make it available to their insureds. They can also assist be preparing checklists that should be followed.

• Review reported injuries and provide feedback on injury prevention. Hindsight is often 20/20. While members of the claim management team are left to deal with the aftermath of a work injury, they are uniquely positioned to advise how to prevent similar future injuries from occurring. This can include spotting common trends and knowing what can be done in the future.

Claim management is a symbiotic circle. Although you cannot do it without employees sustaining work injuries, providing feedback on injury prevention can instill the necessary trust, and confidence in getting the job done right.

Effective Communication is a Must

Effective communication at all levels is important when it comes to claim management. Lack of communication causes countless problems. It also increases mistrust, and lowers workplace morale. The common need among all parties (employee, employer, and the insurance carrier) is the need for effective communication.

• Employee: Information on the claims process and who to contact regarding wage loss, and medical care following a work injury;

• Employer: The need to have the claim handled in a fair, and ethical manner; and

• Insurance carrier: The ability to trust the information received is being done in an accurate, and timely manner.

Claim management teams need to look at common barriers and provide solutions. It also goes beyond returning voice mail, and email messages in a timely manner. When a claim platform is set up correctly, all parties can access the information they require promptly.

Never Forget Return to Work

Claim management teams often rely on insureds, and employers to drive return to work efforts. While they do play an important role, the individual claim handlers also need to be involved in the process. This can be accomplished by tools claim teams have at their disposal. This can include nurse case management, and access to vocational experts. These persons can help the claim handler identify opportunities to get an injured employee back to work in a timely manner.

Conclusions

A new year brings new opportunities to improve the claim management process, and improve claim handler performance. This includes reviewing processes and focusing on areas to establish best practices in areas that drive efficient and accurate claim reporting, a renewed commitment to safety, better communication, and getting injured employees back to work. Do not delay – now is the time to review your claim management processes.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is the founder & lead trainer of Amaxx Workers’ Comp Training Center, which offers the Certified Master of Workers’ Compensation national designation.

Contact: [email protected].

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