A good workers’ comp claim adjuster is a master of coordination. Managing 100-125 open claims certainly stands as proof. Yet, caseloads alone hardly tell the complete story.
For newly assigned claims, information must be collected from the employee, employer, and medical provider. Reserves must be established and reviewed for accuracy. There’s regular follow up with claimants, nurse case managers, attorneys, and other stakeholders. Compensability reviews. Evaluation of settlement opportunities. Mediations to attend. And that only begins to scratch the surface.
Yet according to the Accenture white paper “Claims at a Crossroads,” claims professionals can “spend nearly half their day on activities that do not impact the outcome of the claim.” While those administrative activities may be necessary components of the process, that time is better spent engaged in activities—such as those cited above—that fully leverage the adjuster’s talent and experience, keep claims moving on the path toward successful resolution, and increase the likelihood of outcomes that benefit both employee and employer.
Trying to determine the value of enterprise risk management (ERM) is a difficult challenge. A quotation frequently attributed to Albert Einstein (although more likely originally said by sociologist William Bruce Cameron) gets to the crux of the issue: “Not everything that can be counted counts, and not everything that counts can be counted.”
Issues with measuring ERM value
Donna Galer, writing for the Insurance Thought Leadership blog, summarizes the reasons why the value of ERM programs are not easily quantified:
- It is extremely hard to know when a loss did not happen because of ERM.
- It is just as hard to quantify the cost of loss that did not happen.
- It is difficult to quantify the “soft” benefits of enhanced reputation because ERM is practiced or because of improved strategic alignment in the organization; ERM requires an understanding of the company’s strategic goals and objectives to identify the risks that might derail their achievement.
- It is often hard to justify the time and expense of measuring something that is not easy to measure.
Determining the objective value of a prevented loss or improved strategic alignment is highly problematic. Despite the very real value associated with those activities, determining a specific value without having an actuary assess probabilities and amounts seems extremely difficult. Not everything that counts can be counted.
When it comes to describing the expertise of their employees, there’s very little difference in the way RMIS vendors present themselves. A quick review of provider websites proves it.
“…we strive to have the best talent in the industry on our team.”
“…an ideal blend of business knowledge and technology expertise.”
“…among the most experienced in the industry.”
“…unrivaled industry and technical knowledge…”
If every provider is equal in terms of service expertise, what explains results like these?
(Customer experience and NPS source: 2018 RMIS Report)
Are our competitors stretching the truth when claiming to have the most talented, experienced, and/or knowledgeable support team? Not exactly.
The importance of establishing a near miss culture is clear. The OSHA and National Safety Council Alliance, a cooperative program, puts it this way: “History has shown repeatedly that most loss producing events (incidents), both serious and catastrophic, were preceded by warnings or near miss incidents. Recognizing and reporting near miss incidents can significantly improve worker safety and enhance an organization’s safety culture.” Effective near miss programs can prevent more serious incidents from occurring.
A previous post highlights some of the challenges surrounding this issue. Fear of reprisal or embarrassment, difficulty in the reporting process, and a sense of futility if reports don’t result in tangible changes. Each challenge presents obstacles when trying to establish a near miss culture.
CHICAGO, October 1, 2018 — Origami Risk, the preeminent risk and insurance technology platform serving all members of the risk management community, has been named one of the “Best Places to Work in Insurance 2018” by Business Insurance magazine and Best Companies Group. This is the third consecutive year Origami Risk has gained recognition as having the highest employee engagement and satisfaction.
“We’re honored once again to receive this recognition from Business Insurance and Best Companies Group,” said Robert Petrie, CEO, Origami Risk. “Origami is not only a software company, but also a talent organization that depends on the skills, enthusiasm and creativity of our people. We place a priority on finding people who can best serve customers and providing them with the culture, tools and support they need to be successful.”