It Pays to Be Proactive: How Carriers Can Anticipate Workers’ Compensation Claims Inquiries

Introduction

Nobody anticipates getting injured at work. Sadly, accidents happen, and when they do, the injured worker suddenly faces a flurry of urgent concerns: Will I still get paid? Are my medical bills covered? How long will my recovery take? How will I make ends meet in the meantime? These myriad questions can be overwhelming.

For Workers’ Compensation insurance carriers, staying ahead of these inquiries is not just good customer service; it’s a strategic imperative. Negative claims experiences can lead to costly legal escalations and strained relationships. But by proactively anticipating, and addressing common questions and concerns, carriers can reduce litigation risks, improve medical outcomes, allay injured workers’ fears, and help them return to their livelihoods faster.

The 411 on FAQs

What exactly are injured workers’ most frequently asked questions? To find out, Hi Marley analyzed over 1,000 anonymized conversations in our database to determine the root causes of individual injured worker’s inquiries.

Our research revealed six main categories of questions:

1. Payment (26%). The most common questions related to payments or reimbursements. Injured workers frequently inquire about the status of their checks, payment amounts, and how amounts are calculated. For greater clarity, carriers should proactively outline timing and expectations at the beginning of the claims process and provide status updates throughout.
2. Contact (24%). Many injured workers simply want to feel heard. They need to know how to contact their adjuster to follow up on a question or confirm that the rep has everything they need. These inquiries underscore the importance of clear communication and consistent updates.
3. Providers (22%). Questions about scheduling appointments with providers and obtaining approvals for treatment were the third most common category of inquiries. They highlight the need for streamlined communication between injured workers, providers, and carriers.
4. Process (14%). Workers’ Compensation is complex, and many injured workers feel lost about the claims process, including clarification on the steps involved, their rights and responsibilities, and what to expect at each stage.
5. Benefits (9%). Inquiries about medical benefits coverage and specific reimbursements like mileage, parking, and transportation costs fall under this category. Clear communication about the types of benefits available and how to access them can alleviate injured workers’ confusion and anxiety.
6. Documentation (5%). Injured workers often request copies of medical records, bills, or other documentation for themselves or other parties. Streamlining access to these documents can improve transparency and reduce frustration.

Proactivity Strategies

Understanding these pain points allows carriers to be proactive. By anticipating and addressing these common questions, they can significantly improve the claims experience for injured workers and streamline the adjusters’ process. Here are four actionable strategies:

1. Automatic Payment Updates. Proactive communication about payment status, amounts, and delivery methods can address the most common concerns among injured workers. Automatic notifications can be triggered whenever a payment is issued, providing a detailed breakdown of the payment calculation and information about relevant reimbursements. This transparency can build trust and alleviate financial anxiety.
2. Scheduling Reminders. Automated text messages about upcoming appointments and check-ups can significantly reduce missed visits, keeping recovery and the claims process moving forward. Carriers can customize and send predefined message templates automatically, ensuring that injured workers stay on track with their treatment plans.
3. Manage Expectations Upfront. A comprehensive explanation of the claims process from the outset sets realistic expectations and reduces confusion. Welcome packets, informational videos, or personalized messages from adjusters can clarify what to expect, the steps involved, and the injured worker’s rights and responsibilities. This upfront communication can significantly reduce the number of inquiries related to the process.
4. Show that You’re Listening. Injured workers need to feel heard and understood. Simple confirmations when reps receive documents or process claims can go a long way. Empathy and understanding in all communications significantly improves the overall claims experience.

The Final Word

By combining automation, clear communication, and empathy, carriers can transform the Workers’ Compensation claims experience for all involved, but in particular injured workers. This approach streamlines the process and provides crucial support and empowerment to injured workers throughout their recovery and helps Workers’ Compensation carriers provide the best service to their customers when then need it most.