It All Starts with Preparation
There are several steps a claim handler needs to take when preparing for a mediation. Failure to do so diminishes the chances of success. Now is the time to prepare.
- Setting proper reserves: A claim handler needs to have appropriate reserves set on a file. When a reserve is not set correctly, it can cause delay or not get final authority.
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- Proper Analysis from Defense Counsel: Claim handlers should demand their defense attorney to keep them posted throughout a claim. This includes regular status reporting and offering proper analysis as the facts of a case change. Additional reports should be made after the independent medical examination, issuance of other expert reports, and depositions.
- Using a Roundtable on Difficult Cases: Failing to use a roundtable can cause a problem in legacy and problematic cases. Teams should establish specific criteria for when to roundtable a case to ensure the best strategy is developed. It can also allow the claim handler to grow as an individual and become a more valued member of the group.
- Identifying Settlement Obstacles: A proactive claim handler needs to identify barriers to a settlement before mediation. Common barriers include instances where a Medicare Set-aside may be recommended or if the employer requests a global settlement where the employee will resign their employment as part of the agreement.
Claim handlers who meet the many challenges before mediation see better results. This includes better use of their limited time.
Taking Time to Be Present
One of the primary decision-makers is the claim handler, who has ultimate authority for the defense interests to settle a workers’ compensation case. Delay often turns into failure when a claim handler is not present and available.
The COVID-19 pandemic has taught many people that someone does not need to be physically present at the mediation. It will likely be the case that many in-person mediations will continue to be telephonic or virtual via various WebEx platforms.
Notwithstanding the use of technology to allow people to be available at mediations, it is still vital that claim handlers are present. This includes:
- Being available by at least telephone during the entire time of the event. This requires communication and coordination with defense counsel;
- Having access to other decision-makers on the claiming team, including a claim manager who can authorize additional authority if prudent; and
- It is properly setting goals for the mediation.
Taking these steps improves the chances of success and promotes oneself within the claiming team to get the job done. Never forget the only suitable file – it is a closed one!
Other Steps for a Successful Mediation
There are other things a claim handler can do to ensure success at the mediation. Failure to take these steps reduces the chance of closing the file.
- Coordination with Defense Counsel & Settlement Team: It is essential to be on the same page with the defense attorney and settlement team before a mediation session. Your settlement team includes your settlement advisor and professional administrator. Topics to cover can include a review of the mediation statement, strategy, and determining areas of compromise;
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- Knowing the Other Side: It is important to solicit information from defense counsel on the employee’s demeanor and attorney. This can help uncover barriers that include what might be driving a claim, or understanding the other sides style; and
- Selecting the Right Mediator: It is crucial to understand the style of a mediator. This should be taken into consideration when preparing. This can help bridge the gap when it comes to getting a claim resolved.
Conclusions
Mediation can be an expensive proposition when viewed in terms of time spent on the event. Based on this factor, members of the claim management team need to be prepared as best they can to maximize their settlement changes. This can include properly preparing, being physically and mentally present, and taking additional steps to ensure success. Now is the time to start preparing for your next mediation.
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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