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Experts say advocating for injured workers can curb rising claim costs, avoid litigation

injured worker

Short of maintaining a focus on workplace safety, the workers compensation industry is mostly “along for the ride” when it comes to claims severity, as there is not much that insurers can do to mitigate the upward trend, said Virna Rhodes, Cherry Hill, New Jersey-based senior vice president, workers compensation claims, for Liberty Mutual Insurance Co. 

One area where the industry can curb the rising costs and keep claims from lingering or going into costly litigation is advocating for injured workers, Ms. Rhodes and other experts say. 

“The data is irrefutable on the early intervention, the advocacy model,” said Jason Beans, CEO of Chicago-based Rising Medical Solutions. “If you get in and help them get their care … it tends to be a more trusting relationship out of the gate, and it helps in moving the claim forward.” 

Russell Pass, Itasca, Illinois-based chief information officer, executive vice president of product development, at third-party administrator Gallagher Bassett Services Inc., said the “human side” of claims management is key in managing costs. 

That includes “not leaving workers to wonder, even for a minute, how supportive their employer is going to be” and showing that “we are sitting on the same side of the table as they are in getting them healthy, getting them back to work as quickly as possible,” he said.

Max Koonce, Fayetteville, Arkansas-based chief claims officer for third-party administrator Sedgwick Claims Management Services Inc., said bringing in additional resources — such as assistance with mental health — can pay dividends by helping “calm some anxiety that is naturally part of an injury.”

“You want to address things as soon as possible so they don’t grow exponentially, so it doesn’t drive up the claim,” he said. 





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