First things first, take a look at the sand sculpture from our new friends at Belfor. Talented people. Lots of fun.
Today was a good day on the Exhibit Hall floor. There was less traffic today, but the vendors I spoke to said it was a better day for “real” conversations and business development.
One such vendor was Dave Duden with Deloitte. We had a great visit. I was extremely interested in Deloitte’s new predictive analytic solutions. It sounds a little like “Big Brother,” but I sure can see the application in the claims industry.Essentially what they do is maintain a huge database about a company’s employees – including social media and publicly available data. They also blend personal data with a layer of demographic data which might show traffic accident rates, DUI rates, and other data for a particular geographic area. Then, when a claim is reported (via a First Report tool such as ClaimCompass), they take the name of the claimant and the location of the incident, and run that information against their database to return predictive modeling data. In the 20 minutes we had to discuss it I learned a lot, but obviously need to dig way deeper. Dave and I believe there might be some work out two companies can do with each other. Stay tuned on that one….
I attended a session this morning called Top 10 Things an Employer Can Do to Mess Up a Workers Compensation Claim. Long title, good session. Not quite as good as the one yesterday, but well worth the 90 minutes.
So, what are the top 10? Here’s what the panel said were the top ten mistakes:
1 – Leaving the employee out of the investigation process. In other words, keep the employee involved. Let them know what you are doing, and how you are trying to figure out what happened.
2 – Ignoring Red Flags. These may include: Monday morning claims, obesity, co-morbidity, pre-existing conditions being reported as part of the claim, claims reported later than 24 hours after the incident – wouldn’t happen if they used ClaimCompass.
3 – Alienating the Injured Worker / Keeping them in the dark. There’s already a natural animosity between most employers and employees – especially in large companies. Don’t make it worse by leaving the claimant in the dark.
4 – Failing to report the claim to your carrier or TPA. Sometimes you might think you can handle a particular claim because it’s “med only”, for example. The panel highly discouraged that, saying to report everything. You never know what a simple med-only is going to blow up in your face, and if your carrier/TPA isn’t already in the mix it will make it that much worse.
5 – Not accommodating Light Duty. This may seem like a no-brainer, but the panel said it’s a far bigger problem that you would think. Companies either don’t have a Light Duty option in place, or the one they have is terribly inadequate.
6 – Either terminating or NOT terminating the injured worker. It’s against the law to terminate an employee because of a workers comp claim, so don’t do that :). However, if the injury occurred because of something that is grounds for termination, the panel suggested that you should tell the employee they will be terminated once they have recovered from their injuries. What do you think of that? I would imagine there are some contrary opinions out there.
7 – Abandoning the claim after a favorable IME. Just because an independent medical exam has been done, doesn’t mean you should abandon the claim. Follow it through to the end to make sure nothing flares up.
8 – Not letting your carrier/TPA do their job. This one is related to number 4. The panel emphasized several times the importance of reporting to your carrier/TPA, and allowing them to do their job. Trying to save a little money by not reporting, or ignoring the advice they give you can lead to serious (and expensive) problems down the road.
9 – Refusing the re-hire a claimant. The panel suggested that refusing to ever re-hire someone who has been a claimant can send the wrong message to your workforce, and can lead to more litigation because injured workers will think they have to get everything out of you while they can.
10 – And finally… Having unrealistic expectations regarding the outcome of a claim. Just because you have a “solid case” never lost sight of what could happen. Things tend to come up that you weren’t expecting, or go in ways you didn’t anticipate.
Well, that’s it for today. Another good day here in Philly. Perfect weather, good food, good people. All in all a good day.
About the writer Steve Schmutz and Claim Compass