The Workers Compensation Claims Adjuster

Many years ago, I started out my career as an insurance adjuster trainee. The adjuster has more to do with your Workers Comp premiums than any underwriter, agent, or premium auditor. I thought I would go over a few interesting and probably unknown aspects of a very tough job in the insurance industry.

The Claims Adjuster

One of the most thankless jobs in Workers Compensation or any other type of insurance is the claims adjuster position. In this blog, I may point out flaws in how file reserves and closings are handled by an adjuster. It is not the adjuster, but the Workers Comp insurance system as a whole that causes overcharges in employers’ premiums. The claims adjuster is the “mediator” between the claimants and the respective insurance companies. The claimants want to be reimbursed or provided with whatever they ask, and the insurance company wants the claim to be settled for the least amount of funds possible, without the costs of litigation.

Most claims adjusters are overloaded with claims. A claims adjuster must be the master of time management or they will quickly drown in their claims load. A usual claims load is from 125 – 300 files. If the claims adjuster has over 200 files, you as the customer, are not having your files handled properly. There are a very few adjusters who can handle more than 200 files. If your files are split amongst numerous adjusters, each of them still needs to be handling 200 files maximum.

Anything that will help a claims adjuster do their job can only help keep your reserves as low as possible. The Four Secrets of Saving Workers Compensation premium that I posted previously will help reduce the amount of time spent by the adjuster on your WC files. An adjuster only has so much time to devote to each file, so any extra time that you can give the claims adjuster will enable the adjuster to spend time on your files trying to reduce your costs, not just working on the files.