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High-performing comp claims organizations embrace ‘soft skills’


Developing “soft skills” such as empathy and active listening is fast becoming vital for those who want to successfully manage workers compensation claims, according to a recent survey of high-performing claims organizations.

Chicago-based Rising Medical Solutions on Sept. 18 released the findings of its 10th annual benchmarking survey in which it gathered the input of 388 claims leaders in 2022, identifying how claims organizations with successful claims experiences for injured workers distinguish themselves.

In addition to using technology to assist with workflows and other tasks — now commonplace as the insurance industry as a whole embraces technology — addressing mental health and applying sensitivity-based approaches to managing claims stood out as must-dos for those handling claims.

Paige McCraney, Rising’s vice president of care management and a nurse practitioner, said the move away from “adjudication of claims” to addressing the biopsychosocial issues in workers compensation has been a slow but necessary shift.

“It’s a change of culture and kind of a change of paradigm,” she said. “Historically (in workers comp) we’re looking for fault. And it’s very easy to say, ‘Oh, well, this person has mental health issues and that is really their fault, or that’s not related to the workers comp issue,’ when it actually is caused by the workers comp injury and certainly impacts (the claim) and needs to be addressed.”

Successful claims managers are “connecting with people in a meaningful way,” said Denise Algire, Pleasanton, California-based director of health for grocery chain Albertsons Cos. Inc., who served on the advisory council for Rising’s study. 

“At the end of the day, we’re working with an injured worker dealing with what could be their worst day. Most people … don’t understand the system, and our system can be quite complicated,” she said.

“Having empathy and understanding critical skills like active listening are just as important as the other strategic and tactical skills that claims professionals need in the daily management of claims.”

Dr. Marcos Iglesias, Hartford, Connecticut-based vice president and chief medical director at Travelers Cos. Inc., said the industry in the past steered clear of managing the mental side of claims out of fear they would cross into the mental-injury space.

That notion has not been proven, he said, adding that there’s a difference between having a diagnosable mental health condition and having stress, depression or anxiety when dealing with a physical injury suffered at work and not being able to work because of it.

“We have lumped all of mental health into one monolith, and mental health isn’t a monolith. … Mental health is really a continuum,” Dr. Iglesias said. “At any one point in time, I might be excelling, thriving, or I might be in a crisis and those are two very different ends of the continuum.

“Likewise, within that continuum, I could have a diagnosable mental health condition like schizophrenia or major depressive disorder, or I could be somewhere in the middle where I have symptoms of depression or anxiety, which isn’t a disease or mental health condition. They’re just the way that I’m feeling right now.”

Addressing “how an injured worker is feeling and acknowledging their concerns is the approach successful claims handlers are applying,” Dr. Iglesias said.

The change is slow, Ms. Algire said. Training claims managers is “not something that can be a one-and-done training session. You can’t just get training on empathy. It has to be the ongoing messaging,” she said.