The Role of Compassion in Managing Work Injury Claims

In today’s increasingly litigious environment, it is essential to evaluate our claims practices to ensure injured workers feel supported and cared for, reducing the likelihood of them seeking legal representation.  One of the primary reasons claimants report hiring an attorney is the perception that no one cared about their injury or what they were going through.  As employers and claim professionals, we have the ability to build a rapport with the injured worker so they do feel cared for and heard.  

PartnerSource knows that success in achieving the optimal outcomes is often helped by a dose of compassion—one that often helps avoid larger, more costly scenarios.

Building Rapport

A recent case serves as an excellent example of how compassion and rapport can positively impact claim outcomes.  

An injured worker slipped and fell on a wet floor, which resulted in a fractured patella. It was an identifiable injury that was not questioned. Typically, this would have been a covered injury under the Plan; unfortunately, however, the injured worker was non-compliant with the employer’s drug screen policy. This resulted in denial of the claim.  

The adjuster on this claim had spoken with the claimant on numerous occasions, keeping the injured worker informed on the progress on the claim. Prior to the denial, the adjuster also worked with the assigned nurse case manager to determine what treatment was going to be needed for the injury. Throughout this process, the adjuster maintained contact with the injured worker.  

This communication prior to denial helped the adjuster develop a rapport with the injured worker. Through that, the injured worker felt comfortable enough to discuss with the adjuster about the significant financial burden the denial would now create for her.  The adjuster promptly brought this situation to the attention of the employer and to PartnerSource for discussion.  

Outcome-based Approach

PartnerSource worked with the adjuster to gather medical cost information and to evaluate the potential exposure of the claim. This information was shared with the employer in a meeting to review the claim. PartnerSource also participated in settlement discussions with the injured worker, ensuring excellent communication.  

Ultimately, a quick settlement and resolution of the claim was achieved.  While it would have been easy to issue the denial and take no further action—given the situation stemmed from the claimant’s non-compliance—this approach could have led to attorney involvement and litigation in the future. This outcome was only possible because of the adjuster’s empathetic approach and open communication. PartnerSource was pleased to help the employer put the power of the Texas Option to work in achieving the best possible outcome.

Tips for Showing Empathy in Work Injury Claims:

1) Utilize Active Listening: Fully engage with the injured worker without interruptions. Use verbal cues like "I understand" to demonstrate attentiveness. Patience is key—allow them the time to express themselves fully. This approach not only conveys care but can also yield valuable information for managing the claim effectively.

2) Acknowledge Feelings: Empathize by imagining how you would feel in their situation. Avoid dismissing or minimizing their emotions. Even if you disagree, focus on understanding and validating their experience.

3) Keep an Open Mind: Refrain from making assumptions or passing judgment on the injured worker’s actions or feelings. In the example above, the adjuster’s non-judgmental approach regarding the claimant’s non-compliance helped maintain open communication, leading to a resolution.

4) Follow Up: Regularly check in with the injured worker until they are cleared to return to full-duty work. Consistent follow-ups demonstrate genuine care for their well-being beyond the initial claim process.

By applying these strategies to both catastrophic and less severe injuries, injured employees are more likely to feel supported and less inclined to pursue additional claims or attorney involvement. Remember, your PartnerSource team is always available to assist with claim settlements or provide training on effective claim management strategies.