What injured workers want

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What injured workers want

The bad news: according to workers, positive interactions with insurers are few and far between. The good news: what workers actually want from insurers can be boiled down to three simple requests…

Written by Gabrielle Lis


If you’ve been following along with our series on worker / insurer interactions, you’ll know what workers don’t want from insurers (but all too often get). You’ll know the consequences of these insurer failings. Now we’re going to focus on the positive: what workers do want, and what happens when they get it.

What follows is not an exhaustive wish-list; it’s not a compilation of answers to the question, “What kind of interactions would you like to have with your insurer or claims agent?”

Instead, our list is based on the actual experiences of the workers who say that they’ve had positive interactions with their insurer, and it incorporates quotes from real individuals. (A reminder: the vast majority of the 845 workers who participated in the qualitative research we’re looking at here had a physical injury, and many were long-term claimants.)

Our “what injured workers want” list is modest in two ways.

Firstly, it’s short. (This might be because most workers described negative interactions with insurers; positive interactions were rare in this research.)

Secondly, the items on the list are pretty simple. If we were going to use dessert as a metaphor (and why wouldn’t we?!), we’d say that workers who had a good relationship with their insurer described it as piece of pie, plain and simple, without a scoop of ice cream or a cherry on top.

Despite this modesty, the kinds of interactions described below had a big impact on how workers talked about the workers’ compensation system.

Positive feelings about a particular claims agent seemed to emanate upwards and outwards, so that workers who developed a rapport with their insurer representative tended to think highly of the system overall.

Moreover, workers who described positive interactions with insurers thought of them as allies, rather than adversaries, in the process of recovery and return to work. Unfortunately, workers who felt this way were the exception, not the rule.

Without further ado, then, let’s take a look at what the research tells us about what workers want…

Workers want insurers to guide them through the workers’ compensation system.

“If I had a question I called her, she gave me the answer. If she couldn’t give me the answer she’d call me back in a short period of time and answer my question…”

For many workers, navigating the ins and outs of the workers’ compensation system is a stressful business. They feel overwhelmed by the rules and uncertain about what they have to do when, and why. There is a sense that getting it wrong can have big consequences, but they don’t feel confident that they’ll get it right.

Workers who have positive experiences with their insurer report that their claim manager was like a guide, who helped them successfully navigate their claim.

This can be as simple as answering questions promptly, and providing clear, helpful information about worker rights and responsibilities.

Communication that is respectful, relevant and regular is key.

Workers want insurers to minimise the stress they face.

“The girl I worked with at Workers’ Comp. She was excellent…She made sure everything was done on time, that my check [sic] came, the doctor got their checks [sic].”

Work-related injury or illness is often accompanied by worry: worry about financial stability, about recovery, about future employment prospects and about the social implications of being on “compo”.

Insurers can either add to these worries or help to alleviate them. (A 2016 report by the Victorian Ombudsman contains distressing information about the ways in which insurers can make the compensation process more stressful for workers.)

Workers who reported positive interactions with their insurers in this domain didn’t describe knock-your-socks-off levels of customer service. Instead it was more about the basics.

Payments arriving on time. Help accessing appropriate and timely treatment for their injury or illness. Being treated fairly, and with respect.

Claims managers who demonstrated good administration and a good attitude were highly valued by workers.

Workers want insurers to treat them as an individual.

“You know, it’s like an acquaintance. It’s not like she’s the insurance company, and I’m the employee. It’s a different kind of relationship. I don’t know how to exactly describe it, but that’s best way I could.”

A recurring complaint in the research was the idea of “institutionalised distrust”: a kind of automatic suspicion about the legitimacy of claims that can develop amongst claims managers, regardless of the merits of a particular claim.

By contrast, workers who reported positive interactions with insurers felt that they were seen as individuals.

These workers didn’t expect their claims manager to be their best friend, but they did appreciate the personalised, and personable, service on offer.

Consistency of staffing is key here: you can’t build rapport if you’re dealing with a different claims manager every fortnight.

In addition to the fuzzy feelings that rapport brings, this consistency has a practical benefit: it allows claims managers to take into account a workers’ individual circumstances. This builds understanding, and creates mutual trust, creating an environment supportive of recovery and safe, durable return to work.


*This article is supplied by Return to Work Matters an industry leading in claims management strategies; this article was written by RTWMatters team.  All views, opinions and conclusions expressed are those of the authors and/or speakers and do not necessarily reflect the view, opinion, conclusion and/or policy of ExamWorks and its affiliates.

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