...said every Claims Adjuster.
The past few months we’ve been talking about Return To Work, and specifically a changing industry working hard to overcome the musculoskeletal shift that is the root cost driver in the workers’ compensation insurance segment. What we know is that the moment a negative psychosocial component is introduced at the onset of a claim, that “6-figure eye roll," naturally causes the injured worker to go into benefit preservation mode.
Benefit preservation sounds a lot like pain, and looks a lot like an out of work note. Capturing and responding to that moment in time is the single most important function of claims professionals.
So why is it that from a leadership perspective, we keep creating workflow changes and providing tools that take us further and further away from the real solution? Why do we keep making the job more difficult?
The life of an adjuster and their workflow look a lot like expanding claim loads, jurisdictions and management of vendor process and networks…..like your PBM, diagnostics, PT, phych, best doctors, utilization review, and case management. Digital paper, in our paperless world is stacking up against adjusters to the extent that managing our automation is taking more time than the good ‘ole fashion way. 3-point contacts take a back seat to moving this digital paper back and forth.
True risk management and education of your employers takes a back seat to meetings about moving digital paper, networks and discounts. All the while, employers are rolling their eyes at another injury that wasn’t an “accident.” Where the job caused it and they don’t know how to respond, so they get upset. When they get upset, the injured worker becomes scared….for their actual livelihood. We haven’t given adjusters the right resources to respond to this moment. And it is costing millions of dollars.
And it gets worse before it gets better. “I’ve lost my purpose,” said Jane Adjuster. “I fill a spot, and I push the button and the claim goes.” In our pursuit of automation, we’ve stripped claims professionals of their WHY. Claims is a wonderfully meaningful role, and I’m not sure why we don’t talk about it. Work gives people purpose. It is essential to life! The job of returning people back to work is an extremely important one, one to be proud of. We are.
If we infused that purpose back into claims, and attacked that 6-figure eye roll MOMENT by educating, by showing empathy and finding the solution…..we wouldn’t be experiencing the cost inflation that still plagues workers’ compensation despite all of the “savings” we keep hearing about.