Get Better Claims Results by Building A Connection with Injured Workers

Introduction

Claims adjusters play a pivotal role in the workers’ compensation system. Their primary responsibilities include determining compensability, providing prompt and accurate benefits to legitimately injured workers, and defending the employer and the claims administrator when the claim is litigated. To do their job well, they must establish rapport with injured workers at the beginning of the claim.

As a new claims adjuster, I found the most challenging nuance of the job was creating a connection with the injured worker. With a few, I instantly connected; many began the relationship wary about my intentions; surprisingly, some blamed me for their accident, and more than a few hated me from the get-go. Even with many calls at different times of the day, many of the workers never answered the phone. I learned that positive outcomes for the injured worker and my results came from my relationship with the injured worker. Whenever I got an injured worker on the phone, I worked diligently to create a connection with them.

Many injured workers are wary of the intent of the claims examiners because they believe the examiners are charged with denying benefits. Creating a relationship with injured workers is a skill that can be learned and improved through practice. Building solid relationships can lead to better information gathering, more accurate benefit provision, and a smoother claims process.

Basics of Creating a Relationship

Establishing a strong rapport with injured workers is essential for effective claims management. The following principles are foundational to building these relationships:

1. Active Listening: Demonstrate genuine interest, ask follow-up questions, paraphrase and summarize what the worker has said, and avoid distractions during conversations.
2. Building Trust Through Self-Disclosure: Share relevant information about the claims process and use techniques like the Fast Friends Procedure to foster deeper connections.
3. Creating a Balanced Conversation: Balance talking and listening, avoid overwhelming the injured worker with complex information, and ensure they have ample opportunity to express their thoughts and feelings.
4. Enhancing Empathy and Understanding: Validate the worker’s feelings and use empathetic language to acknowledge their experiences.

Fast Friends Procedure

The Fast Friends procedure is a method designed to quickly build intimacy and trust between individuals through structured conversation. This technique involves asking a series of progressively more personal questions, which helps foster a deeper connection. For example, you might start with general questions about their work before the injury, and then move to more personal inquiries like their hopes for recovery. This gradual deepening of conversation can help the injured worker feel more understood and valued.

Modern Methods of Communication

Today’s injured workers may prefer alternative communication methods over traditional phone calls. Adjusters can apply the basics of relationship-building to these methods:

1. Text Messaging

• • Recognize Preferences: Many injured workers prefer texting over phone calls. Respect this preference and use text messaging to maintain communication.
  • Active Listening in Texts: Just as in phone conversations, demonstrate genuine interest by asking follow-up questions via text. For instance, if the worker texts, “I’ve been in a lot of pain,” you might reply, “I’m sorry to hear that. Can you tell me more about where it hurts and how it’s affecting your daily activities?”
  • Clear and Concise Messages: Ensure texts are clear and concise. This helps the injured worker feel more comfortable and less overwhelmed.

2. Video Calls

• • Offer Video Call Options: For those comfortable with technology, video calls can provide a more personal touch compared to phone calls or texts.
  • Personal Interaction: Use video calls to establish a stronger connection through face-to-face interaction. This can help convey empathy more effectively. Apply active listening by nodding, maintaining eye contact, and summarizing what the worker says during the call.

3. Email Communication

• • Detailed Information: Use email for detailed communications that the injured worker can refer back to when needed. This is particularly useful for explaining complex aspects of the claims process.
  • Professional and Friendly Tone: Maintain a professional yet friendly tone in emails to build rapport and trust. Apply active listening by acknowledging their concerns in your responses, and ensure you address all their questions thoroughly.

4. Chatbots

• • Understanding Chatbot Interactions: Chatbots can handle routine inquiries and provide immediate responses, which can be helpful for both the injured worker and the adjuster. However, it is crucial for the adjuster to understand the nature of the questions and responses provided by the chatbot.
  • Monitoring and Personalization: Regularly review chatbot interactions to ensure accuracy and appropriateness. Personalize responses where necessary and follow up personally on more complex issues that a chatbot cannot adequately address.
  • Integrating Human Touch: While chatbots can be efficient, they should not replace human interaction. Use insights from chatbot interactions to inform more personalized follow-up communications.

Conclusion

Effective communication is the cornerstone of successful claims management in workers’ compensation. Claims adjusters can improve their relationships with injured workers by applying the basics of relationship-building to modern communication methods. Active listening, building trust through self-disclosure, balancing conversations, and enhancing empathy are as essential in texts, emails, video calls, and chatbot interactions as they are on the phone. These strategies lead to better outcomes for the worker and contribute to a more efficient and compassionate claims process.