Claims Adjuster Crisis – What Happened?
A claims adjuster crisis has been developing since the 1990s. Bill Zachry wrote a great article on the current conditions in finding and retaining claims examiners. I recommend reading it.
Very few Workers Comp articles are saved to my Windows 10 desktop. Bill’s was one of them.
I call them claims adjusters – Bill refers to them as claims examiners. Regardless, the claims examiner crisis has taken a very long time to slowly develop into a crisis.
See this seminal viral article of mine from long before the claims adjuster crisis on whether or not AI can replace claims adjusters. The secret is they cannot be replaced due to the need for human interaction at the start and continuing throughout the claim. See my next article on what can be done to partially substitute AI to replace part of the claims adjuster duties.
Some insurance carriers have taken this one step to alleviate some of the tasks that drive claims adjusters crazy. Kudos to those carriers and TPAs that have implemented a simple AI mechanism (very simple).
Static Job = Claims Adjuster Crisis
By the way, claims examiners/adjusters have 13 distinct duties that they perform daily. I still have a few claims that I handle for employers/agents as a consultant. Static job descriptions could be one of the problems. I wrote the article at the preceding link in 2011 and nothing has changed that much in the daily work life of a claims adjuster.
As a former claims adjuster working in the trenches, let us cover the headings from Bill’s article. I am going to cover the most critical ones, in my opinion, from the claims department standpoint. I am sure he will not mind if I use them.
Talent/Skills Gap
When I was attending the NWCDC Conference (Vegas Conference) in 2015, a presenter from Westfield Insurance warned the audience that she had noticed and then analyzed the brain drain in Workers Comp. She pointed out that the ability to find and train Workers Comp adjusters was diminishing rapidly.
Claims management noticed the workers comp claims adjuster crisis 20 years ago. I noticed it at conferences. Where is the younger crowd at safety and insurance conferences? There was not one to be found anywhere. Younger insurance agents were everywhere, not so much with claims handlers.
Cost of Claims Transfer = Big Claims Adjuster Crisis
That was the perfect heading in his article. When I review claims for employers, carriers, TPAs, etc., this is the flashpoint that I see so often in files. The greater the number of adjusters on a file, the worse the files turn out.
Most of the time, I would say that I see (on average) 2.5 claims adjusters per file. That number has increased from under two to almost three now. A claims adjuster crisis in the area of turnover remains a concern. File continuity goes down quickly. The injured workers have built a relationship with the adjusters – now that has been destroyed by turnover.
Training/Education and Salary
Many claims adjuster job candidates will tell an interviewer (such as myself) that education and pay are their major concerns. The education part seems more important now to claims adjuster job candidates than in the past. Remember that in five seconds, the post-baby boomer candidates from millennials and forward can download an educational app on their phones in a matter of seconds.
Salary will always be the driving force in recruitment and retaining of the more non-glamorous jobs. Competitive pay has always seemed to be lacking in the workers comp claims adjuster profession.
Ironically, I, left an IT career to join up with a claims department as the pay was competitive. That was some time ago.
Bottom Line
Bill’s article covers many more topics. Something needs to occur now to stem the claims adjuster crisis in place. Thinking that AI will replace many of the job functions is a slippery slope into the valley of mistakes.
