In Defense of WC Claims Adjusters

Wednesday, June 16, 2010 | 0

By James J. Moore
J&L Risk Management Associates

One of our services is to review files to see how the claims adjusting staff performed on a group of claims. I had recently read a LinkedIn post slamming workers' comp claims adjusters. The poster had recommended to the other readers to challenge an adjuster by asking them to on-the-spot give an immediate answer on a claim. I see this in posts and artifices approximately twice per year.

Asking an adjuster to discuss one file on-the-spot is the same as asking someone what they had for lunch over a month ago. We recommend that an employer establish a working relationship with their adjusters. Expecting an adjuster to not pull the file and review it before giving an answer or status is going to leave an employer disappointed.

We always recommend emailing adjusters and expecting an answer to the email within 24 business hours. This allows the Workers Compensation adjuster time to review the part of the file to give an acceptable answer. An email is very strong written documentation for the employer and the adjuster.

I wrote about this situation in a manual that I wrote on controlling Workers Comp costs.

James L. Moore is owner of J&L Risk Management Associates, an employer consulting firm based in Raleigh, N.C. This column was reprinted with his permission from his blog, http://blogs.cutcompcosts.com/