In the world of workers’ compensation, the focus is often on claims processing, legalities, and the complexities inherent in the insurance business. However, what if the secret to improving outcomes isn’t just in the numbers or policies but instead lies in a powerful yet often underutilized tool: empathy? In our recent podcast episode of Adjusted, we dive deep into how integrating empathy into the claims process can lead to more effective resolutions and, ultimately, happier employees and adjusters.
Empathy in the workplace is not merely about being kind; it involves putting ourselves in other people’s shoes and understanding their emotions, fears, and challenges. In the claims industry, empathy manifests during every interaction, whether with an injured worker, their family, or even the medical team. As the director of catastrophic claims, our guest, Hope Remetta, emphasized that empathy allows adjusters to gather important facts about the personal circumstances surrounding a claim. This is crucial because injuries do not exist in a vacuum; they impact every aspect of a person’s life.
Adjusters can find it challenging to balance the need to make judgments while also being empathetic. While their job requires them to analyze claims and render decisions, adjusters can still approach their conversations with kindness and compassion. This delicate balance can be achieved by first seeking to understand the injured worker’s situation and recognizing the stress they are under. This perspective can enhance communication and decision-making, leading to more informed and compassionate outcomes.
One key challenge in the industry that often hampers the ability to practice empathy is the heavy workload placed upon adjusters. High caseloads can force them to prioritize efficiency over connection, leaving little room for the necessary empathy that could facilitate better communication and understanding. Karyl Bierwagen, a seasoned claims specialist with 20 years of experience, noted that adjusters are frequently pressured to close claims as quickly as possible, which can diminish their capacity to engage meaningfully with injured workers.
To combat this, our company, Berkley Industrial Comp, has embarked on a path to foster a culture of empathy within its framework. We’ve implemented an empathetic resolution model, encouraging adjusters and nurse case managers to prioritize meaningful interactions with injured workers. Maintaining manageable caseloads ensures adjusters have adequate time to get to know the injured worker’s situation, facilitate discussions, and advocate for their holistic needs.
A pivotal aspect of this model involves communication before making decisions about a claim. Our team revamped initial claim letters, transforming them from legal jargon-filled documents into more straightforward, client-friendly communications. This way, injured workers can understand their rights and what to expect without feeling overwhelmed by complex terminology. Moreover, this proactive communication lays the groundwork for building trust, something that can dramatically sway the outcomes of claims.
Alongside effective communication, it can also be helpful to approach injured workers with gestures of kindness. By sending a thoughtful gift, whether a box of cookies or a small token, to recognize their hardship, adjusters can enhance the emotional well-being of the injured party. One of our team members recounted a heartfelt story about an injured worker who received cookies; his surprise and appreciation were evident, showcasing that simple acts of kindness can make a significant difference in a difficult time.
Despite the reality of having to deny claims due to policy infractions or other reasons, showing empathy remains crucial. Karyl recalled an instance where an injured worker faced a denial due to a DUI charge associated with their injury. Although the claim could not be covered, Karyl still reached out with a compassionate conversation, offering resources that could help the worker navigate their situation. Working through a denial with empathy not only alleviates anxiety for the worker but provides a pathway toward possible solutions.
Communication among all parties – adjusters, policyholders, and medical teams – is paramount as well, particularly when dealing with the complexities of claims. Maintaining transparency throughout the process helps establish trust. Clear communication channels can bridge many gaps and foster collaboration, which is particularly effective when everyone’s on the same page and engaged in achieving the same goals.
Ultimately, investing in empathy isn’t merely about compliance or checking boxes; it’s about improving the lives of those we serve within the workers’ compensation framework. As we look ahead, it’s clear that empathy has the potential to not only reshape the perception of claims management but also enhance the operational efficiencies of adjusters and overall satisfaction for injured workers. It’s about rethinking how we approach our roles within this complex industry and finding ways to embody compassion and connectedness in our everyday practices.