Does Injured Worker Advocacy Really Matter?

We all like the idea of our injured workers bragging about their experience with a TPA or an insurance carrier, especially when it creates a desired outcome for all parties. It makes an organization more reputable and (competitive advantage) provides a unique attribute one can market in this space. But does it really matter? Spoiler alert. It does.

Injured workers want to be involved in their healing process. There is a lot that is out of the scope of their control, creating feelings of helplessness. Taking a collaborative approach and involving the injured worker in their recovery process can increase buy-in, accountability, and a successful outcome.

Injured worker advocacy is much more than just a “nice to have” in claim operations. The outcomes are important and value it provides to an insured as well as the feelings of helping another from the adjuster side add additional emphasis for the push to move the needle forward. According to the Rising Benchmarking Study, an injured worker advocacy-based claims model is defined as an employee-centric customer service claims model that focuses on employee engagement during the injury recovery process, removes adversarial obstacles, makes access to benefits simple, builds trust, and holds organizations accountable to metrics that go beyond cost containment.

The injured worker advocacy-based type of model is not something that will just happen on its own, as identified in the 2019 Rising Benchmarking Study where 72% of frontline adjusters stated they did not know what an advocacy-based claims model is and 2017 Rising Benchmarking Study showed 50% of claims leaders did not know. The 2016 Rising Benchmarking Study showed 39% of organizations had implemented or were implementing this type of claims model with 61% with zero plans to execute this strategy.

Soft skills needed to cultivate an injured worker advocacy-based claims model include empathy, active listening, communication, critical thinking, and customer service as outlined in the 2016 Rising Benchmarking Study.

There are five steps to taking this from talking about an injured worker advocacy-based claims model to executing.

1. Determine Your Strategy
2. Figure Out What You Want to Create
3. Find the Right Advocates
4. Understand the Types of Stories that Resonate
5. Map Out Your Distribution Plan

1. Determine Your Strategy. As with any other strategy or change management technique, you should not simply hit the ground running without a roadmap in place. What are your goals for your injured worker advocacy-based claims program? What exactly are you trying to accomplish? There are a lot of reasons out there to cultivate movement from the standard claims approach to the injured worker advocacy-based claims model. What resonates with you and your organization?

• Are you looking to attract more candidates to open claims positions?
• Are you looking to rebrand your organization and looking for useful content?
• Are you looking to foster a more positive reputation for your organization?

Getting clear on what the end game looks like for your claims organization is important so you are able to make strategic choices with the vision in mind. Imagine how your program will work. Think about the outcomes and then work backwards. Communicate this to the stakeholders involved so there is one shared vision everyone will be working towards throughout the change.

2. Figure Out What You Want to Create. One of the biggest benefits of building an injured worker advocacy-based claims model is having stories you can actively promote and share to inspire others to buy-in to the concept as well as understand the difference. These can be shared with clients, insureds, and with the adjusting teams to express the importance of the advocacy-model.

Think about photos, videos, quotes, emails, letters, or all of them! The injured worker advocacy-based model showcases more than simply cost savings and doing the right thing, it showcases impact on people’s lives which can evoke emotion within your organization. Story telling is powerful. This content helps showcase clear direction and values of your organization, especially when enlisting your adjusting teams to help.

3. Find the Right Advocates. In an ideal world, every adjuster and leader who was in the workers’ compensation industry would buy in to this process, brag about how wonderful it is, and the industry would change by moving the needle towards a more desirable outcome. However, it is important to remember that not everyone is going to buy-in or feel comfortable being vocal about their experiences and that is okay. An injured worker advocacy-based claims model only works if people are genuinely excited about being a part of it. Authenticity shines through in this capacity and leadership is not excluded.

Start by identifying which of your adjusting team is truly passionate about their work with injured workers and see the value in what they are doing to make good things happen. Adjusters who are already excited about this process, and may already be doing it, make this process fabulous because they become excellent advocates to get others to come along with for the change to take form. If these people do not exist, do not fear, ask for volunteers to think outside the box and bring upon positive influence in the workers’ compensation industry, one person at a time.

4. Understand the Types of Stories that Resonate. Once you have your injured worker claims advocates, it is time to hear about their experiences by having them share their stories. It is powerful to know you have helped influence the life of someone, even more so, by someone who can never repay you. These stories evoke emotion and drive meaningful purpose into the daily adjusting life. If we marketed the game-changing aspects affiliated with an injured worker advocacy-based claims position, maybe there would not be so many open positions in the industry… food for thought.

To uncover authentic stories, you must ask the accurate questions as many times, it is hard to find these stories of impact and influence. Many times, these stories become highly-personal and can be very motivational not only for the team but the organization too! As your adjusting team:

• What do you like most about working here?
• How has the way we changed handling claims impacted your typical work day?
• What is the most challenging thing you’ve worked through with an injured worker?
• What three words would you use to describe our culture?

5. Map Out Your Plan. Once you have done the work and are able to showcase wins, share them with the world! What you are doing matters and how you choose to share these wins will not only have impact to the injured workers, the adjusters who helped along the way, the employer who had a positive experience, and the agent who placed the business, they will have your organization seen in a new light because you took the road less traveled. And it mattered. When you are cultivating change within an organization and taking it into an injured worker advocacy-based claims model, not only does the claims part change, the people change. We can make every day better for one another. The more we can share that this is an easy thing to do from actively listening to an injured worker, to reiterating the payment has been made to them, and calling them back timely with proactive information they need to continue along the road to recovery, the better this industry will continue to be.

Start small. Know your own scope of control and the littlest of things mater. Saying ‘how are you?’ and then taking a pause to wait for an injured worker to respond is a great place to start. Little wins become big wins. Big wins can be life changing. Shine through to make this a priority. If the pandemic taught us anything, it was the power of human connection. Start today. If not now, when?

By Claire Muselman

Dr. Claire Muselman is a workers' compensation enthusiast (and Vice President at North American Risk Services).

Share This Article: