Case Study: The Empathy Factor in the Claims Equation
From colleagues in this industry, we often hear the question, "How could I have handled this claim differently to reach a better end result for the injured worker?"
With more than 25 years of experience, PartnerSource has proven that putting the injured worker first is the simple solution to the claims equation. The design of any injury benefit plan should revolve around the needs of an injured worker. To accomplish this, PartnerSource steps into the shoes of the injured worker, considering how their needs can be met before that person is ever injured on the job.
Take, for example, this particular case: A worker sustains an injury that requires surgical intervention, post-operative care and time away from work. She fears a hardship on her family following the event and is concerned about the unknown. Immediately upon notice of the incident, the adjuster contacts the injured worker, listens to her concerns and explains the occupational injury benefit plan. At the same time, the nurse case manager advocates for the injured worker by teaming with medical providers and answering the injured worker’s questions concerning treatment and recovery.
In this case, it’s easy to see that the claims adjuster and nurse case manager made the choice to empathize with the injured worker, understanding her concerns about her situation and keeping the worker at the center of their thoughts and actions. In doing so, the team made the injured worker feel supported during a challenging time. She also felt valued and informed during the claim process. The injured worker was so moved by the care she received that she sent a card to the adjuster, thanking the adjuster for "helping her put her life back together."
When an incident occurs, PartnerSource clients have a solid foundation in their occupational benefit plan that encourages empathy. It is our philosophy when you take care of the injured worker, positive results will occur, so one of the most valuable tools to use when advocating for injured workers is empathy.
Empathy can be the difference-maker to an injured worker. It can be conveyed by sending a "get well" card or flowers during a hospital stay. It can be as simple as asking the injured worker if they have concerns about their injury or their benefits. It can be as intuitive as listening to understand how an injured worker feels. The outcome of showing empathy is that participants feel that they are being heard and that they have an advocate during the claims process.
In this particular case, the Texas injury benefit plan provided for the medical and financial needs of the injured worker without the red tape found in the workers’ compensation system. The adjuster and nurse case manager were able to provide the support the injured worker needed without her feeling like a claim number. In leading the design of the plan to keep the injured worker at the center, PartnerSource helps solve the claims equation for clients, keeping everything in the positive for all parties.
The adjuster on this case sums up the claims equation best: "We try to make the process as personal as we can while being cognizant of their feelings. It is our responsibility to care for the plan participants. They are valued by our claims team. It doesn’t take much effort to show them we care about their well-being while following the benefit plan."