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Creative claims settling

Creative claims settling

Experts say workers compensation claims handlers need to think outside the box to devise settlements that help injured workers resolve long-standing cases.

Gift cards, hot tubs and, in one case, a new boat, are examples of ways in which some difficult claims have been brought to a close.

While such offerings may seem peculiar in a workers comp setting, they can help resolve claims that otherwise could stretch on for years, said Kathryn Tazic, Chicago-based senior vp with Sedgwick Claims Management Services Inc.

“We've found a need industrywide to start creating other opportunities for settlements that really would be more innovative than traditional,” Ms. Tazic said.

Greg Gitter, president of San Diego-based Gitter & Associates Inc., said the key to settling many difficult claims is listening closely to what an injured worker needs or wants.

“Sit down with the person, have a conversation and find out what's important,” said Mr. Gitter, whose consulting firm works to resolve high-exposure workers comp claims.

Ms. Tazic said Sedgwick has seen an increase in injured workers who want gift cards to a preferred retailer as part of their workers comp settlements. At times, such cards can be loaded with as much as $10,000, she said.

She said she believes the weak economy has prompted more claimants to accept settlements in gift card form.

“Depending on where or how the gift card's applied, it would (provide) the ability to meet everyday needs,” Ms. Tazic said “So if it's a grocer, they know that they can feed their family.”


Mr. Gitter's firm has devised several settlements that go beyond traditional cash offers. In one case, he worked with a claimant who was reluctant to accept a $50,000 settlement.

In conversations with the worker and his attorney, the man mentioned that his dream was to spend his time fishing for bass in Oregon. Mr. Gitter used that information to offer the worker a $38,000 bass fishing boat plus about $8,000 in cash.

The worker accepted the offer almost immediately, he said.

“It didn't change the value of the case,” Mr. Gitter said. “It didn't change anything about the case other than the manner that we approached the settlement.”

Dave Dietsch, Kansas City, Mo.-based vp of claims for Lockton Cos. Inc., L.L.C. said the broker's claims managers at times have offered hot tubs or gym memberships in lieu of cash that would be used for an injured worker's physical therapy expenses.

Mr. Dietsch said he believes such settlements appeal to claimants' emotional side, providing them with benefits or amenities they may not otherwise have been able to afford. They also provide immediate, concrete benefits for injured workers who worry that cash may not cover their future expenses, he said.

“You tie it to a finite number, as opposed to having to negotiate something open-ended, where they may be more reluctant to accept the dollar figure because they're not sure it's sufficient,” Mr. Dietsch said.

While claimants theoretically could use lump-sum settlements to make purchases or investments of their choosing, Sedgwick's Ms. Tazic said workers want to accept settlements that meet their unique needs.


“It depends on the individual, their psychological issues and… where they want to spend their money,” she said.

Emil Bravo, Itasca, Ill.-based executive vp with Gallagher Bassett Services Inc., said the third-party administrator has used creative settlements. But he cautions that workers who receive unique settlements may inspire their co-workers to seek similar benefits if they suffer a comparable injury.

“If the person has a similar injury, their expectation is that they want the hot tub, plus a settlement, too,” Mr. Bravo said. “You have to be prepared as the employer…to buy it for anybody else that asks for it.”

Creative thinking in workers comp can help improve costs and case management for workers comp claims that aren't heading toward settlement, said George Neale, Boston-based executive vp and general claims manager with Liberty Mutual Group Inc.

One Liberty Mutual claim involved a Texas woman who lost use of her legs and one of her arms after suffering a work-related hand injury. Mr. Neale said the woman's paralysis was believed to be caused by a combination of psychological factors and a medical condition in which not using one limb gradually provokes paralysis in other areas of the body.


The claimant eventually asked Liberty Mutual for a new wheelchair to replace her existing one, even though she wasn't entitled to receive one, Mr. Neale said. Rather than turning down her request, a nurse case manager and claims adjuster offered the wheelchair as a condition of the woman going to a physical rehabilitation facility.

In addition, the duo sent the woman flowers and called her regularly to motivate her to stay in treatment. Today, the woman is able to walk again, said Mr. Neale, who did not know the status of the woman's claim.

Mr. Neale said claims handlers should pay close attention to a claimant's requests and needs to find clues that can help move a claim toward resolution.

“You have to listen to them and you have to be able to empathize with them, and you have to create a little bit of a bond,” he said.

This story is from the August 13, 2012, issue of the weekly print edition of Business Insurance, a special issue featuring an in-depth look at how to tackle your toughest workers compensation claims.

Copies of this issue, which includes a data poster on the workers compensation insurance market, are available for $100 by contacting our Single Copy Sales department at 888-446-1422.

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