2024 Reminders for Claims Operations

I would like to thank all of you who have diligently read our “Simple Ideas” papers during the past year. I admit that a few of the papers we sent out were actually not “simple”. These papers are either focused on improving outcomes for the injured workers while reducing costs for the employers, or are designed to help bring you up to speed on the latest technology which will impact you and the industry.

If you have any specific issues which you find challenging or if you have any comments on these papers please do not hesitate to send me a note (zachry@plethy.com). I particularly appreciate any feedback you may have.

Bill Zachry

The 2024 Reminders for Claims Operations are designed to enhance the productivity and success of every claims organization. Some of these recommendations are focused on the individual and some are focussed on the department. I put a few in there because I thought you would find them amusing. As a manager or supervisor you may want to send out some of these reminders to your staff at the beginning of the month. Or as an individual you may want to set the reminders in your calendaring system. If you are in safety, underwriting, audit or any other workers’ compensation function the concept of adopting monthly reminders for events during the year applies to you as well. Create your own reminders for you and your folks. Feel free to adapt them to align with your specific department, company jurisdiction, and culture requirements.

January:

• Self-Reflection: Take a moment to assess your career progression. Identify key lessons learned from the previous year. Ensure that your personal goals align with the organization’s objectives.
• Gratitude: Express your gratitude to coworkers and vendors who have contributed to your success with their hard work and dedication.
• Indemnity Rate Awareness: Be sure to inform your staff about any changes in indemnity rates that may occur at the beginning of the year, and ensure that they are adhering to the new rates.
• Legal Updates: It is crucial to have your legal staff or legal vendors update your front-line staff on any changes in laws and regulations that become effective on January 1.
• Workspace Preparation: Start the year with an organized and clutter-free workspace. Archive old data and materials to maintain efficiency.
• Goal Setting: Establish and communicate departmental goals for the year ahead. Make sure that all team members are aware of their specific goals and committed to achieving them.
• Monthly Claims Metrics: Implement a monthly reporting system for claims goals, including closure ratio, reopening
• ratio, shelf life, subrogation, and cost avoidance, to monitor performance.
• Claims Manual Updates: Update your claims manuals and internal policies, and ensure that your staff is well-trained on any changes in laws and regulations.
• Review and update your safety manual (Your employees should know how to manage catastrophic events in your facility or office).
• Performance Reviews: Conduct (update) performance reviews either annually or according to each employee’s start date, ensuring that all employees’ progress is tracked consistently.
• Health and Safety: Promote health and safety within the workplace by emphasizing the importance of handwashing, mask-wearing, and social distancing to prevent the spread of illnesses.
• Privacy and Security Training: Confirm that your internal privacy and security training programs are scheduled and being followed to maintain compliance.

February:

• Case Discussion: Set schedules for case roundtable discussions and prepare a list of catastrophic cases for review and targeted closure.
• Subrosa Opportunities: Utilize President’s Day weekend and “ski” week for subrosa investigations.
• Gardening Reminder: Prune roses after President’s Day for garden maintenance.
• Health Tips: Promote dental health, fresh breath, and heart health by encouraging regular flossing and adequate hydration.

March:

• St. Patrick’s Day: Consider utilizing St. Patrick’s Day for subrosa activities in regions or cities where it’s applicable.
• Daylight Saving Reminder: Remind employees to check their smoke alarm batteries when adjusting their clocks for daylight saving time.
• Legal Updates: Invite attorneys to provide updates on changes in case law and conduct legal case reviews.

April:

• Casualty Claim Preparation: As the weather improves there is usually a corresponding increase in claims frequency. Prepare your operations to handle increased claims frequency through staffing analysis and targeted hiring if necessary.
• Case Closure Focus: Work diligently to close high-dollar and aged inventory claims in anticipation of the incident increases that typically begin at the end of May.
• Claims Examiner Training: In many jurisdictions, April is a good time to ensure compliance with claims examiner training requirements.
• Tax Day Negotiation: Consider using the approaching Tax Day as a negotiating tactic with certain claimants to facilitate settlements.
• Easter Subrosa: Continuing the theme, Easter week vacations can provide an opportunity for subrosa investigations.

May:

• Summer Vacation Planning: With summer vacations approaching, schedule them to ensure employee happiness and claims unit coverage. Prioritize scheduling based on seniority rather than position.
• Memorial Day Subrosa: Utilize the Memorial Day weekend, typically a three-day break at the end of May, for targeted subrosa activities.
• Incident Increase: Traditionally, Memorial Day marks the start of an increase in casualty claims due to warmer weather.

June:

• Vacation Impact: Acknowledge that increased employee vacations can reduce the frequency of reported accidents. However, be aware that grocery industry claims tend to spike during the summer months.
• School Break Challenge: Recognize that children often get out of school in mid-June, creating challenges for parents with increased demands at home. Encourage supervisors to work with employees to address these issues, promoting better attendance and productivity.
• Flag Day and Father’s Day: Highlight Flag Day on June 14 and Father’s Day.

July:

• Fourth of July Subrosa: The Fourth of July weekend provides another opportunity for subrosa activities if needed.
• Baked Beans Month: July is National Baked Beans Month, which is noteworthy, especially for regions involved in bean production.
• Mid-Year Review: As you reach the halfway point of the year, it’s an ideal time to review your progress and strategize on the necessary steps to achieve your goals.

August:

• Actuarial Assessment: Many companies conduct actuarial assessments at the end of the month. Evaluate whether your efforts to close high-dollar and aged inventory claims have paid off.
• Back to School: Emphasize the importance of the first day of school, encouraging parents to spend extra time visiting their child’s classroom, which can lead to increased productivity.

September:

• Labor Day Subrosa: Labor Day weekend presents another opportunity for subrosa activities.
• Back to School Night: Encourage all parents of school-age children to attend back-to-school night. If necessary have them leave work early enough to ensure that they get to the school on a timely basis.
• Birthdays: September and October have the highest number of birthdays in the year. If you are a supervisor make sure that you have all of your employees birthdays in your calendaring system and that you recognize every persons birthday.

October:

• Safety Awareness: As the days become shorter, emphasize the importance of safety for employees commuting on public
• transportation. Encourage vigilance and readiness for potential safety issues.
• Halloween Celebration: Embrace creativity in your employees during Halloween with costume contests and fire-safe office decorations.
• Casualty Claim Decrease: After Halloween, anticipate a decrease in casualty claims as the weather gets colder and customers reduce their outdoor activities.
• Flu Season Preparedness: Encourage hand washing, flu shots and mask wearing for those who believe in preventive measures.
• Hunting Season Subrosa: In certain regions, the first day of hunting season can be an optimum time for subrosa investigations. (notice a theme here?)
• Leaf Warning: Advise employees not to park their cars over piles of leaves due to the potential fire hazard caused by hot car components.
• Storm Warnings: When severe storms are pending remind the employees that their safety is paramount. Driving through blizzards are to be avoided as much as possible. Be aware of black ice and other driving hazards. The first storm of the season usually brings up oil off the tarmac and can result in particularly slippery streets.

November:

• Claim Closure Focus: Refocus on closing cases, as claimants are may be more interested in settling prior to the holidays.
• Daylight Saving Reminder: Remind employees to adjust their clocks for daylight saving time and check fire alarms.
• Changes in the time are also associated with increased heart attacks.
• Thanksgiving Sub-rosa: While Thanksgiving weekend can be challenging for subrosa due to people being at home or in their cars, monitor weather forecasts for potential opportunities.
• Snowfall Sub-rosa: The first significant snowfall is often an excellent opportunity for sub-rosa investigations as some will be shoveling snow. Keep an eye on your region’s weather forecast.

December:

• Drunk and Drugged Driving Prevention Month: Recognize December as a month for raising awareness about drunk and drugged driving prevention. Remind your employees about the dangers of driving while impaired.
• Year-End Reports: Analyze year-end reports to assess results and set goals for the upcoming year.
• Vendor Invoices: Encourage vendors to submit outstanding invoices for payment by year-end to maintain positive relationships.
• Compliance Reminder: Remind staff of the importance of complying with company gift policies.
• Claims trading month: Claims supervisors; take the five claims where your examiner hates the claimant and trade them out for five different claims where there is no negative history.
• Year-End Data Capture: Collect any necessary year-end data from 2023 for year-end reports and comparisons.
• Data Backup: Use this time to back up data on your PC or laptop to prevent data loss.
• Year-End Cleanup: The quiet week between Christmas and New Year’s is an excellent time for examiners to clean their desks, remove old paperwork, and update contact lists.