Are Task-Centered Processes Hurting Workers’ Comp Claim Control?

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Over the past four decades it has been fascinating to watch the evolution of the workers’ compensation claim handling process. In terms of structure and complexity, it has moved from the bicycle to the jet aircraft. Today’s process is composed of numerous secondary support personnel (vendors) and sophisticated analytics that aid the claim representative. In the past, there was only the claim representative and the medical representative.

The task-driven process can cause tunnel vision: We miss the real issues and challenges as we check the boxes.

There’s no question the medical landscape is far more complex today than in years past and the general environment far more litigious. Today’s environment does require a sophisticated approach to medical cost containment, and there’s no question today’s process is more effective than the past. So, is there is a concept from the past that may improve present outcomes?

Connect and Control

My career in the claim profession began during a time in history when face-to-face contact was the norm. The foundational principle behind this concept was “connect and control.” The better the connection with the injured employee the more control we had over the direction of the claim. We met with the injured employee to truly understand their concerns and fears, and we guided them and their family through a very trying time and complex process.

At times claim representatives did not possess the necessary training and skill set to operate in this emotionally charged face-to-face environment. We sometimes referred to them as magicians because they could change a perfectly good claimant into a really bad claimant with just the sound of their voice, facial expression or body language – an amazing power.

Today’s Task-Driven Process

I am not suggesting we return to a time of face-to-face contact. However, I am suggesting we examine whether today’s complex and task-centered process is a barrier to establishing the level of connection required to effectively control a claim.

The task-driven process can cause tunnel vision: We miss the real issues and challenges as we check the boxes. My experience in the claim profession tells me the connection is not to the level it can or should be. Can the connection be improved in today’s telephonic, electronic, e-mail world? Yes, but it requires change.

First, as long as the process rewards task-driven behavior, nothing will change. If change is to occur, the claim representative evaluation system must be based on outcomes and not task completion.

Secondly, the claim representative must be trained in the science / art of communication and listening. They must have the skill set and ability to interact with people to gain their respect and trust in a very short time frame. This means hiring the right personality type and investing in their training.

The past and present have one common thread – it’s about people – people with emotions that are magnified in stressful situations. The calm, reassuring, respectful and knowledgeable voice on the other end of the phone can vastly improve outcomes.

So what is one concept we can bring from the past that will help our sophisticated process today? A deeper understanding of the power of “connect and control” – because workers compensation will always be about people.

About Jeff Seibert

Jeffrey Seibert has managed a number of catastrophic events during his 37 years in the claim profession. As Nationa…
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