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Collaboration, communication keys to claims success

Collaboration, communication keys to claims success

SAN ANTONIO — Collaboration among employers, attorneys and claims adjusters is critical in helping to better manage workers compensation claims and keeping litigation costs down, say those in the trenches of closing injured-worker claims.

“It never ceases to amaze me (how) we don’t talk,” Glenn Backus, president of Nashvillebased third-party administrator Alternative Service Concepts L.L.C., told attendees at The Risk & Insurance Management Society Inc.’s annual conference Monday in San Antonio. “There are a lot of silos in the industry.”

Mr. Backus moderated a discussion with Misty Price, chief operating officer for Van Nuys, California-based law firm Adelson, Testan, Brundo, Novell & Jimenez, and Suzanne Ormond, risk manager for Alsco Inc., a large uniforms and laundry firm based in Salt Lake City with more than 80 plants nationwide.

All three presenters work to close workers comp claims for Alsco, which before a team approach became a part of risk-management operations in 2015 spent upwards of 40% of its comp costs on litigation, said Ms. Ormond. One culprit, she said, was a lack of communication between all those involved in closing the claim.

Ms. Price acknowledged the root of the communication issues that often prolong claims.

“There’s a lot of volume in the industry … So much happens all at once,” she said, adding that it’s easy for information to miss the right eyes.

Today a collaborative approach has helped speed claims along, said Ms. Ormond.

The company has what Ms. Ormond calls a “communication wreath,” lending to the image of a circle, where all parties are involved and understand where a claim is in the process. “Build a communication wreath,” she said. “It’s my team, his team and her team … everybody knows the process and their role in it.”

It can be as simple as copying all involved parties on emails regarding a claimant, which Alsco now requires of its attorneys and claims adjusters to do at the onset of a claim. It can also mean setting regular meetings or checking in regularly on claims, said Ms. Ormond.

This eliminates the “Monday morning quarterback” issue often cited as a problem with prolonged, complicated claims, when “you look at things that were missed,” said Ms. Ormond.

Ms. Price emphasized the importance of the simple step of regular communication and data sharing.

Prior to her work in the legal field, Ms. Price worked for an insurer. When she went to a law firm, she was surprised how difficult it was to gather information on a claimant outside of a file that was sent to her office. Also surprising was a lag in getting approvals from employers, she said.

“What we kept hearing (from our attorneys) was, ‘I went and asked for authority and I couldn’t get it three years ago’… And now, three years later, we are settling this claim for more,” said Ms. Price.

A collaborative approach ensures “all the right eyes have the opportunity to see what they need to see,” she said. “In those unique situations that need review … the client can jump in to keep things on track.” 


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