Work Comp Adjusters – A Controversial Subject
Most Work Comp adjusters have a very strict authority level in the internal working of a claims department. The subject of having to receive authority from the employer/insureds can often be an exercise in frustration.
The previous blog article that I had written on this subject generated many questions by work comp claim adjusters and employers.
The claims adjuster trainees, claim adjuster, senior claims adjuster, supervisor, manager and Vice President all have an increased authority level for settlements and/or reserves. The adjuster may have to hold six or seven meetings just to have the reserves or settlements approved internally.
Certain employers may request a type of special claims handling on a file. This results in the adjuster after having several meetings internally to hold a meeting with a person or persons that may not completely understand the Workers Comp process.
Technology has eliminated many of the adjusters’ concerns that they may not know the level of when an employer is to be contacted before a settlement offer is made or large reserves are pending. The claims department’s computer system may not allow the settlement offer or large reserves without having internal approval.
More than a few work comp adjusters are concerned they may increase the reserve levels or initiate a settlement offer without an employer’s approval. The adjuster very rarely handles files for one or two employers. Some systems will advise the adjuster to contact the employer when a reserve or settlement offer (for instance) is over $100,000.
I have actually seen an employer contact request when any reserve, compensation payment, or medical bill was more than $5,000. The adjuster(s) spent more time asking for employer authority which made the file handling for that employer suffer over time.
There is a delicate balancing act on requesting that an adjuster make contact with a settlement or reserve authority request and not interfering with the 13 daily responsibilities of work comp adjusters.
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