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The #1 Factor Affecting Workers Compensation Outcomes

Posted by David Ross on Sat, Sep 16, 2017

Reduce Workers Compensation Insurance Fraud by Building Trust. Serving Philadelphia, Lancaster, Reading, Allentown, Harrisburg, Pittsburgh, Erie, PA and beyond.Trust… What is trust? Merriam Webster defines it as “one in which confidence is placed” or “assured reliance on the character, ability, strength, or truth of someone or something.”

But what does trust have to do with workers’ compensation claims? EVERYTHING!

Studies have found that the biggest single factor that determines the success or failure of a workers’ compensation insurance claim is trust between the injured employee and his or her employer. And that trust (or lack of trust) begins as soon as the claim is reported (often before).

Workers Compensation Insurance Fraud is Rare. Surprised? 

Now, you may be thinking that there are so many cases of Workers Compensation Insurance fraud that you can’t trust anyone. We have an interesting statistic for you: studies show that only 1 to 2 percent of all workers' compensation claims are fraudulent. That means 98 to 99 percent are legitimate. So, yes there should be a thorough investigation of every claim, but you should also give your employees the benefit of the doubt. After all, trust is a two-way street.

How to Build Trust

Here are two areas that employers should focus on when trying to develop trust, plus one magic question that can help lead to a mutually successful claim.

#1. Work on The Employee / Supervisor Relationship

Research has shown that a supervisor’s response to an injured worker at the moment the claim is reported is key to building trust, and once trust is lost, it’s very difficult (if not impossible) to get it back.

If the supervisor responds with blame or anger by saying something like “What did you do to cause the injury?” there will be an immediate lack of trust. Perhaps even worse is expressing apathy with something like “You’re not hurt; get back to work.” Both of these show a lack of trust in the employee and puts them immediately on the defense.

If the supervisor responds positively by taking every workers’ compensation claim seriously and by showing genuine concern for the employee’s well-being, trust is built. And with trust you will have a significantly better claim outcome.

Supervisors should continue to leverage that trust by following up with a call or a visit to the hospital the day of the injury to let the injured employee know how sorry they are that he or she got hurt and how eager they are for the employee to return to work. Follow this up with a get well card signed by the supervisor and the injured employee’s co-workers. Again, say something like, “We’re so sorry that you got hurt. We look forward to seeing you back at work.”

The supervisor should continue to solidify that trusting relationship over time with weekly conversations reaffirming that they care about the employee’s well-being. These discussions also allow the supervisor to assess the attitude of the injured employee, how their medical treatment is going, and how their transitional duty job (if there is one) is going.

#2. Work On The Employee / Insurance Adjuster Relationship

First impressions are crucial. If you present a positive reaction to an injured employee during the first interaction, it’s much easier to build that trust. The adjuster should avoid using insurance jargon, such as “adjudication” and avoid calling the injured worker the “claimant."

And remember that this is probably the employee’s first workers comp insurance claim, so they probably don’t understand the process, what is going to happen, or what they need to do. It’s up to the adjuster to guide them through the process as a trusted advisor. If the injured employee believes their rights are not being protected, they will call an attorney, which often makes a claim even more complicated and more costly.

#3. Ask The “Magic” Question

One of the most powerful questions you can ask an injured employee is, “Do you think you will be back to work within four weeks without any restrictions?” If they say no, ask them why and offer additional resources and support. If they answer yes, they’ve set the expectation in their mind, which will drive them back to work more quickly. This question helps builds trust and should be asked with every Workers’ Compensation claim.

This may sound like a lot of work, but if you want to resolve workers’ compensation claims quickly and minimize your workers’ compensation insurance claims costs, these are necessary actions.

Contact Us To Learn More About Workers Comp Insurance 

A Trusted Choice Independent PA Workers Comp Insurance AgencyTo learn more about saving on workers compensation insurance, contact American Insuring Group online or call at (800) 947-1270 or (610) 775-3848.

Our independent insurance agents are motivated to help you save on the best workers comp plans from reliable insurers.Best of all, as independents we are free to shop among lots of competing insurance providers, so you can be confident of getting a great price on the right coverage!

For helpful tips and plenty of insightful blog posts on the topic, visit our Workers Compensation Insurance page.

Tags: Workers Compensation Insurance, workers comp costs