The Future of Workers Compensation Claims Handling

People

Attracting and retaining talent to the insurance industry, and workers compensation, in particular, has been a persistent challenge. With estimates that one-half of our workforce will retire in the next 10 years, the need to attract younger employees becomes even more urgent. At the same time, we also need to preserve the knowledge base held by aging baby boomers who will be leaving.

Losing a claims examiner on an account is challenging because it can take 6–9 months for the new examiner to learn the employer's culture, processes, and expectations. That means we have to focus not only on finding new employees but making sure we can retain the talent we recruit into our industry.  

Millennials are the next large group coming into the workforce and are the key to the future of workers compensation. This generation is comprised of people born between the early 1980s and the early 2000s. Their numbers are staggering. This age group is expected to exceed that of baby boomers by 2019!

Communications, media, and digital technology are hallmarks of these younger workers. They have grown up using smart phones, tablets, computers, and apps in both their social and educational lives. That means we need to focus on providing top technological resources in our organizations to attract and keep them.

We also need to understand who they are so we can design jobs around their core values and interests. Through research and experience, we know they are highly focused on making a difference in society—some even more than making money. They want to work in a company that shares that ideal.

Retaining millennials is another challenge. Research shows the trend for recent college graduates is to stay in their first jobs for no more than 2 years. Working as a claims examiner or claims adjuster, for example, can be frustrating. Holding onto these younger workers for any length of time requires having the right culture within an organization and finding ways to make their jobs meaningful.

Caring Culture

Fortunately, there has been somewhat of a shift in recent years that coincides with the goals of these younger workers. Some organizations are becoming increasingly concerned with improving the experience of customers, including employees and injured workers. These companies want their employees, clients, and vendors to focus on preventing injuries and truly care for employees who do become injured.

Within these companies, soft skills are crucial. Empathy and concern, as well as positive and effective communication with injured workers, are as important or more important than the technical aspects of processing the claim.

Creating a positive culture is key to holding onto good workers. Organizations that demonstrate a commitment to caring for their employees are attractive to employees who want to make a difference in the world. Companies can do this by highlighting safety efforts to prevent injuries and focusing their efforts on delivering quality service to injured workers to help them quickly heal and return to work.

It is important that your claims handling process reflects the service culture of the employer. Treat injured workers with the same respect you would have for your customers. You should also look to eliminate negative terminology being used in claims handing, such as the word "denial." Instead, injured workers can be told their claims were "not approved" and introduced to the other group benefits they have available to cover the medical condition in question. The tone used from the very first conversation with the injured worker sets the course for the entire claim process.

Keep It Simple

"If you can't explain it simply, you don't understand it well enough." That quote from Albert Einstein explains one company's approach to employees and injured workers. Part of its training focuses on providing better customer service by explaining things simply and easily.

The company also uses direct deposit for injured workers. Since the company began that process, it no longer receives phone calls saying a check was not issued. The insurer requires the money to be deposited 3 days before it is actually due.

Making employees' jobs easier is also a key goal of evolved organizations. Our speakers said that they constantly assess the tasks within jobs to find those that really do not matter at the end of the day. This allows workers to spend their time on the things that are most important.

The entire claims process should be constructed in a manner that makes it as easy as possible for the injured worker and those processing their claims. Organizations can see how well they are doing this by surveying both groups.

One way to measure the experience of injured workers is through the use of Net Promoter Scores, a management tool that gauges the loyalty of an organization's customer relationships. Much of the health industry, as well as consumers, are measured this way.

Technology

A big part of the change occurring in workers compensation is the use of technology. Automation, for example, could potentially process thousands of routine claims. But a key point to understand is that technology should not be a way to eliminate people. The human element is vital to effective claims handling.

Instead, robotics, artificial intelligence, and other types of technology can be employed to handle the more mundane aspects of a claim, allowing the claims examiner to spend more time on areas of a claim where they can truly add value and make a difference. Technology should enhance or augment human expectations.

Ultimately, the use of technology should be determined through a collaborative effort among the various stakeholders involved. The overall goal is to ensure the best outcomes possible by using automated intelligence to get the right cases to the right decision-makers at the right time.

Places

According to our panelists, office space with few walls and no set locations for specific workers is the wave of the future. Flex space locations, bright colors, areas for group work, and some sit/stand desks are increasingly being utilized in the industry. These enhancements encourage employees to work more collaboratively.

In some companies, managers have no offices, and employees decide where to sit each day. Some employees report that this setup creates more opportunities to better understand what other department members actually do. One speaker said a worker reported that sitting next to a nurse on occasion gave him more insight into medical aspects of claims.

Teleworking is also becoming more attractive to both employees and organizations as they struggle to find affordable real estate. Technology allows companies to support people in a variety of locations. Employees who work from home use tools such as Skype and video chats to engage with coworkers and others. Many organizations are also switching to cloud-based infrastructures so that data and resources can be accessed from any computer in any location.

Our speakers added that, by unanswered phone calls and emails, it is readily apparent if someone is not suited for working from home. Those who can effectively work remotely, however, have lower turnover rates and higher productivity.

Things

InsurTech and other industry disruptions have generated hype for the last several years. But how does that occur in an industry such as workers compensation with its heavy regulation and legacy claims systems that cannot be changed quickly or easily?

As we heard, it is more a matter of evolution than disruption, and it can be either intimidating or enlightening. It is important to remember that the younger employees entering the workers compensation industry have grown up surrounded by technology and will not tolerate working on mainframes for very long.

Instead of full-scale, complete changes, organizations can look at various components of their systems and adopt newer technologies to improve their processes. In addition, machines can do some things expertly but can never replace the human touch.

One speaker stressed the importance of keeping the human in the loop. At some point in an automated process, there is a need for a live person. Systems should be developed with the built-in ability to allow a person to take over and make decisions at the appropriate time.

It is important to keep regulators informed of any technological changes that are made to avoid spending time and money on something the organization will not be able to use. It is also wise to consider any possible unintended consequences that may arise.

The evolving workforce and changes in technology will change the face of the workers compensation system. The question is, will we be ready?