Study: Avoiding Litigation: What Can Employers, Insurers, and State Workers’ Compensation Agencies Do?
This case study is taken from The Seltzer Group’s monthly “WorkComp Advisory” e-newsletter.
The Workers Compensation Research Institute (WCRI), a Cambridge, MA nonpartisan, not-for-profit membership organization, recently released a study, Avoiding Litigation: What Can Employers, Insurers, and State Workers’ Compensation Agencies Do? that provides valuable insights into the reasons injured workers seek representation by an attorney and how employers might avoid costly and lengthy litigation.
The study concludes that injured employees who feel threatened are more likely to seek attorneys. The perceptions of threats arise from:
– The employment relationship. Workers believed they would be fired as a result of the injury, and/or workers perceived that the supervisor did not think the injury was legitimate.
– The claims process. The worker perceived that the claim was denied, although it was later paid. This perception may have stemmed from a formal denial, delays in payment, or communication that the worker deemed to be a denial.
The study suggests that attorney involvement can be decreased if employers, claims organizations, and state agencies reduce or eliminate unnecessary actions that workers interpret as threats. These include:
– Train supervisors: Help supervisors create timely communications that focus on trust, job security, and entitlement to medical care and income benefits.
– Create state agency education materials and help lines: Provide written materials and an accessible help line that answers workers’ questions to help ease feelings of vulnerability and uncertainty.
– Communicate in a clear and timely fashion about the status of the claim: Prevent misunderstandings through explicit, timely communication from the claims manager so the worker does not mistakenly conclude that the claim has been denied.
– Eliminate system features that encourage denials or payment delays:
Help prevent a worker’s misconstruing a delay as a denial by improving the processing of claims.
To start receiving our monthly newsletter containing workers compensation and other business updates and tips, please email us at firstname.lastname@example.org or call 1-888-366-1000. As always check back here at Risk Management 24-7 for our daily blog.
The Seltzer Group with locations in Schuylkill Haven, Orwigsburg, and Pottsville, Pennsylvania, serves businesses and individuals locally, regionally, and on the national level. The Seltzer Group is a proud member of the Keystone Insurers Group.