Presented by Plethy Recupe

Simple Ideas for a Complex System

In a World of Negativity - It is Time to Get Positive

In a World of Negativity - It is Time to Get Positive

by Bill Zachry, SCIF Board Member &
Steve Hunckler, SVP, Claims at CNA

The workers’ compensation system is rife with negative experiences and outcomes.

When workers get hurt on the job, the accident is usually not their fault. They are thrust into a confusing system where the incentives are not always aligned to achieve optimum outcomes. If they cannot return to work, they may suffer severe financial losses and even have a reduced mortality. Injured workers may blame their negative experience on the system on the claims examiners, or their employers. Sometimes, the injured worker is right to blame the claims adjuster. Many times, they are blaming the wrong person.

Examiners are tasked with nurturing and supporting the injured worker. After bending over backwards to take great care of the injured worker it can be a disappointment when the claim is litigated.

One of the largest cost drivers in workers’ compensation is a poor employer / employee relationship. Some employers inappropriately blame their injured workers for the impact to their experience modification or their bottom line. Sometimes they take out their anger on the injured worker. Many times, they also direct their anger at the claims examiner for following the prescribed claims handling process.

Sometimes the employer delays the report of the claim hoping it will go away. Any delay in reporting the claim by the employer increases litigation and always results in significant increases in the claims costs.

In an attempt to manage their losses (and resulting increase in the premium), employers may have their broker representatives attempt to bully the examiners to reduce the reserves.

Some employers do not provide adequate settlement authority in a misguided attempt to reduce the settlement costs. This always results in increased caseloads and increased claims costs. Sometimes employers even sue the insurance carrier (and the claims adjuster) for inappropriate claims handling.

Applicant and defense attorneys have pitched battles trying to maximize or minimize benefits. Friction from the litigation process increases claims costs as well as increases caseloads. Applicant attorneys subpoena, depose, and even sue the examiners in an attempt to extort better settlements.

Claims executives are trying to control overhead expenses that may include, in some instances, carrying higher caseloads. These actions leave the examiners overwhelmed with a high volume of claims.

Turnover in the claims offices also results in transitioning higher workloads for the examiners with limited or future relief in sight.

All this negative activity can take an emotional toll on the claim examiners.

One way to counter all of this negativity (and improve employee retention) is to look for every opportunity to create positive experiences.

The injured workers are the ones in the workers’ compensation system who need the most support and encouragement. Even when the injured worker focuses misplaced anger on the claim’s examiner, the examiner has to remain positive.

Here is a preliminary list of three buckets (because there is always three), of positive successes and experiences that should be celebrated in a workers’ compensation office.

  1. Personal to the individual
    • Birthdates
    • Wedding Anniversaries
    • Achieving educational degrees (BA, MA, MS, PHD, Certificates of completion and skills from recognized organizations)
    • Awards
    • Holidays (potlucks are grea)
  2. Personal to the family
    • Weddings
    • Mother’s Day
    • Father’s Day
    • Holidays
    • Children / spouses / partners (births, adoptions, first day of school,
      birthdays, graduations, awards, honors)
    • Grandchildren births/milestones
  3. Professional accomplishments to the individual
    • Promotions
    • Work Anniversaries
    • Hiring
    • Employee referrals
    • Settlements
    • Take-nothings
    • Successful fraud referrals/convictions
    • Letters from customers
    • Completion of difficult tasks
    • Completing a task for the first time
    • Supporting others in the job or office
    • Overtime or extra time taken to complete a task
    • Completion of projects (and celebration of milestones)
    • Completion of training
    • Industry designations
    • Idea Generation
    • Successful negotiations

Each company should create its own culture on how to celebrate success. This process should be done regardless if the employees are all on site, remote or hybrid. Recognition from senior management/leaders of success is worth its weight in gold.

With all the negativity it is particularly important that the claim examiner remains positive in the interaction with the injured worker. The injured worker needs the financial and emotional support that a good examiner can provide. The nice thing about positivity is that it breeds success and good outcomes. This is particularly true with the interaction between the examiner and the injured worker.

Every profession has its own accomplishments to celebrate. Create your own list. Get senior leaders involved in recognition of personal and professional accomplishments.

In a negative industry positivity will always get you positive outcomes.

Leave a Reply

Your email address will not be published. Required fields are marked *

Skip to content