Analogies to an experience every single person has as the end recipient of a business transaction were frequent at the Alliance of Women in Workers' Compensation mini-conference on advocacy based claims management in Boston the day before the annual Workers' Compensation Research Institute's meeting.
What is advocacy based claims management?
The short answer is - doing the right thing.
The challenge is changing a culture based on skepticism and mistrust.
Much of the panel discussions came from large, self-insured employers; a distinct minority in the work comp world, and a subset that has an entirely different agenda, different mind-set and with much greater resources, than the great majority of the insured work comp world.
For one thing, each of these big companies don't call their employees, "employees." Terms like partners, associates, and cast members come from a culture of top down appreciation for the human assets of the company and an understanding of the import these people have on the experience of the purchaser of the goods or services of the business.
When the folks doing the presentations talked about their injured workers they were nearly universally referred to as "customers." It's a change in mindset, a change in culture, a different way of looking at how we approach the issue of a work injury or illness.
Workers' compensation is a people business. It doesn't get any more simple than that. The job of work comp is to take care of people. When dealing with people, relationships matter. A lot. The customer analogy of the injured/ill worker fits. They are the end recipient of the goods and services of The Grand Bargain. The moment a worker comes into the work comp fold that customer relationship has started.
Business literature is replete with lessons about the customer relationship; the very best companies, those that excel over and above the competition, have a very basic, common core: solid relationships with their customers.
We know that intuitively. Even in the business of workers' compensation, really successful companies build and maintain relationships with their customers; and really successful claims management builds relationships with THEIR customers.
Just because it's simple, though, doesn't mean that it's easy.
Indeed, in one of the collaboration break outs one of the attendees, a vice president of an employer work comp trust acknowledged that many of his members don't have that same regard for workers as those self-insureds up on the stage, noting that their expectation for paying $50,000 in premium is that the insurance company just takes care of everything - and are surprised when asked to take the worker back!
So the business, the entity that has the workers, itself first needs to recognize that its workers have value and that workers' compensation is not a vehicle for other human resource issues.
And within a claims organization, how a successful claims experience and/or relationship often is not measured according to customer-based metrics. Instead of gauging the quality of the workers' compensation encounter, we measure compliance, either regulatory external compliance (don't want those penalties) or internal company compliance (get a bonus for closing 120% of your case load!).
Imagine if you were a retail customer and wanted to buy something, but in the store you were met with skepticism, the subject of investigation. Instead of a sales person showing you, for example, different shoes, you were instead asked why you would want any shoes in the first place ("What's wrong with the shoes you have now?")!
Or at a restaurant and you really wanted a rib-eye steak, but the waiter told you that you were too fat to be eating steak and that he would only serve you a salad...
Yet, that's how we traditionally meet the injured worker at first contact. Instead of a compassionate question about fears and expectations, we initiate investigations...
Know your customer (i.e the person being serviced). This seems obvious, but in workers' compensation we don't take much time to know our customers, or what they really need to return to health, and ultimately back to work. For various reasons, the culture of the workers' compensation claims process does not allow the development of beneficial customer relations, and consequently the customer, i.e. the injured worker, is disengaged from a process in which they should otherwise take ownership.
The devolution of workers' compensation has taken many, many years. Turning the culture around, bringing value back to the customer, making the injured worker a part of their own solution, will likewise take many years.
But efforts like those of the Alliance of Women in Workers' Compensation will, I think, build momentum because there's a very solid business case: continue to treat the customer poorly and eventually you go out of business.
It's that simple.
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