While it seems simple, developing a clear and effective action plan to resolve open claims can be difficult. The plan should define parameters for settlement, stakeholders and what needs to happen for a claim to be settled. For example, extending monetary offers as opposed to simply inquiring into a claimant’s settlement interest. An effective resolution may also require companies to think strategically about where and when to invest and how to reduce costs during the claims settlement process. A strategy session should include adjusters to ensure consensus on the claim’s direction, which will help them shift focus from a task-based tactical approach to a more results-oriented strategic approach.
“Adjusters are trained to conduct initial investigations and compensability decisions, but often lack the training to strategically resolve claims closure,” adds Himbera. “Therefore, it’s important to partner with them to help manage and resolve costly aged claims.”
According to Aon Claim Closure Services data, 71 percent of aged claims (greater than one year from date of loss) have reached maximum medical improvement (MMI) and are primarily open for palliative treatment. When a claim reaches MMI status, there are few remaining settlement barriers. These claims should be targeted for resolution to avoid future decline.
Percent of Claims that Reach Maximum Medical Improvement Status
Aon’s data further indicates that 35 percent of aged claims are in settlement posture. Claims that remain in this position often lack a specific direction and expertise to expedite resolution.
Workers Compensation Claims Settlement Status