2022 US Insurance Awards: Broadspire, TPA Team of the Year

Managing workers compensation claims for New York’s largest health care organization during the COVID-19 pandemic was unlike any challenge the Broadspire Services Inc. team had experienced before, said John Lastella, vice president of claims.

Broadspire, the third-party administrator arm of Crawford & Co., has handled Northwell Health’s workers compensation program since 2013. The health care system has more than 80,000 employees across 23 hospitals, said Hauppauge, New York-based Mr. Lastella. 

“When the pandemic hit, Northwell was hit really hard,” he said. “A lot of their employees were exposed to COVID, and they didn’t have a choice but to take care of people.”

Broadspire worked with Northwell to determine how many employees were exposed to the virus on the job, which amounted to about 7,000, Mr. Lastella said. Workers comp claims were then opened for each employee who contracted the virus, totaling about 2,500, to compensate for missed work time and any medical needs. 

To improve the efficiency of the claims-handling process, Broadspire built a database to track COVID-19 exposures, testing and claims across Northwell’s hospital system. Each claim was categorized by seriousness of exposure. Workers with significant illness, or long COVID, were assigned Broadspire nurse managers who ensured they received proper medical care. 

“Each claim had a different approach, and we tried to categorize them and provide whatever resources, depending on the severity of the case, as quickly as possible.”

There were also health care worker claims related to mental and physical exhaustion, as well as other physical injuries. 

“Everybody was pulling double or triple duty — I don’t know how they did it,” Mr. Lastella said.

Today, about 40 to 50 claims remain open. Though the experience didn’t compare to what Northwell’s health care workers endured, Mr. Lastella said, it took a toll on Broadspire adjusters, many of whom worked 16-hour days, five to six days a week for several months straight. 

“COVID was something that was totally new, and they had to learn really quick and use their best judgment in a lot of scenarios. They were just tremendous,” Mr. Lastella said.

Most of the 2,500 claims occurred between March and August 2020, when there were a lot of unknowns. It was a scary time, but Mr. Lastella said he’s proud of how his team came together to support Northwell’s health care workers through compassion and cooperation.

“That was the focus — there was nothing else. It was just how do we get them through this and what is the best route,” Mr. Lastella said.

FINALISTS

• Cannon Cochran Management Services Inc. — CCMSI implemented artificial intelligence in its claims operations, enabling the company to identify complex claims earlier and automate tasks.

• CorVel Corp. — The company worked with a retailer client to improve its claims process, including its pharmacy program.

• Gallagher Bassett Services Inc. — The company developed its Waypoint Litigation Solution, an artificial intelligence tool that identifies problem claims.

• Helmsman Management Services — The Liberty Mutual Insurance Co. unit uses its early severity model to identify workplace injury claims that are likely to be more complex and expensive.