Alan Gurvey states claims adjusters and their executives must consider the interests of everyone involved. “The bottom line is, ‘What is your goal?’ Is your goal simply to save money for the insurance companies at anyone’s expense, or is it to be effective professional, benefit-delivery personnel?”
Originally published by WorkCompCentral as authored by Tonika Reed
In Rising Medical Solutions’ seventh annual Workers’ Compensation Benchmarking Study researchers exploring claims operational issues from the perspective of claims processors uncovered matters regarding the ongoing threat of a talent shortage.
Rachel Fikes, chief experience officer and study program director at Rising Medical Solutions, said in a statement, “We’ve got a perfect storm threatening the workers’ compensation industry right now.”
This perfect storm Fikes refers to is a mixture of the talent shortage and caseload increase that the claims industry is now contending with.
"Overall, the most significant challenge facing claims organizations today is a talent shortage," the report reads. "The U.S. unemployment rate has remained steady, averaging 3.6% in 2019. The converging forces of the aging U.S. population and retirement of Baby Boomers creates an even greater exposure for the workers’ compensation industry. Compounding these issues is a pending mass exodus of experienced claims professionals — juxtaposed against the continued challenge of attracting young professionals to the industry. Success in this area will require organizations to think outside of traditional talent management and recruitment strategies.”
Denise Algire, director of risk initiatives and national medical director of the Albertsons Cos. was the principal researcher and report author. She said there could be a more “holistic approach” to reversing the talent shortage and managing the increase of cases.
Algire said, “It’s not perceived to be a “sexy” profession if you will, so I think more needs to be done to explain, or maybe to socialize the exciting career that insurance offers, because there are so many different things, including claims, that I think perhaps a lot of new grads are not aware of.”
Fikes seems to agree, and states that there has been a sort of marketing crisis when it comes to recruitment of new insurance talent.
“Our industry has done a poor job of communicating the meaningfulness of our work and the value and aid we bring to America’s injured workers,” she said. “No matter the age, studies have shown that meaningful work is important to all employees. Coupled with that, younger workers tend to value the social impact of their work on society more than past generations. We’ve got all the right ingredients to attract new talent, we just have to be better communicators.”
One issue explored in the study is the "advocacy based claims model" and whether it might help the industry attract new talent. The benchmark study describes the model as "an employee-centric customer service claims model.”
When claims handlers were asked if they knew what an advocacy based model was, only 28% of them answered ‘Yes’, meaning 72% of claims handlers are not explicitly aware of the advocacy aspect of their job, according to the study.
Fikes also said, “Only 25% of frontline staff receive training on empathy — a critical skill when dealing with people who are injured.”
Alan Gurvey, managing partner of Rowen, Gurvey & Win said the study is not comprehensive enough. He states claims adjusters and their executives must consider the interests of everyone involved.
“The bottom line is, ‘What is your goal?’ Is your goal simply to save money for the insurance companies at anyone’s expense, or is it to be effective professional, benefit-delivery personnel?” Gurvey said.
Gurvey added that because “there is too much minutiae involved in the law,” claims adjusters, doctors, and applicant attorneys need to all work objectively together to help injured workers get the treatment that they need as soon as possible so that they can get back to work. The benchmark study listed “similar perspectives on desired claim outcomes and obstacles” as one of the key trends and opportunities.
The study says, “Organizations should consider focused training on the importance of (return-to-world), the impact on human capital, and positive employer/employee relationships.”
Gurvey also cited the discord between attorneys, claims handlers and doctors as one thing that may discourage young people to apply for jobs in the insurance industry.
Fikes of Rising Medical Solutions said the benchmarking study’s “findings are similar to previous claims executive survey results, and demonstrate that [the] industry’s mission to restore workers to gainful employment and health is not window dressing or marketing fodder, it is believed at all levels of the claim ranks.”
You can request the complete Workers’ Compensation Benchmarking Study by Rising Medical Solutions here.