Insight, analysis & opinion from Joe Paduda

< Back to Home

Jun
29

It’s the workers’ comp industry’s fault.

Yep, it’s your fault that the popular press smacks you around, citing a few examples of alleged insurer screwups as proof that you’re all a bunch of cold-hearted, nasty, lazy incompetents motivated only by profit.

Gun-Point-Suicide-Attempt

When was the last time your company actually talked publicly about the good stuff you do?  The patients you help?  The above-and-beyond service you provided to the paraplegic who needed something expensive and special that you approved so they could get on with their life? The spouse you spent hours on the phone with, explaining how work comp works, when the checks would be there, how you’d make sure her husband would get the care he needed?

The hugely expensive inpatient drug detox to help a long-term opioid user get clean, get her life back, and perhaps return to work?

(update-  the good folks at Midwest Employers are sharing their work on YouTube.) Kudos to MWECC – and here’s hoping a) they do more of this and do more to publicize it and b) others follow suit)

The lengths you went to to prevent a young woman from being subjected to cervical implant surgery, knowing that the outcomes for patients with her condition were universally poor?

The dangerous drug interaction you prevented, despite the screams of protest from the claimant’s physician and/or attorney?

Wait…you never publicly talked about this?  Never once mentioned it, much less actually – God forbid – used this an example of the good work your people do?

Never published a case of the month, or sent out a release honoring one of your employees for going above-and-beyond in helping a work comp patient?

Then stop your bitching about ProPublica, NPR, the plaintiff’s bar, and muckraking journalists and bloggers.  Because it’s your fault.

There are a bunch of reasons why insurers, TPAs, and funds don’t do this – all of them short-sighted, ignorant, and indefensible.  Fact is, if you don’t tell your story, others will. And in the work comp industry’s case, those “others” have bludgeoned you near to death with some true, real life examples of major screwups, along with many mis-interpreted, mis-understood, or just plain BS examples of alleged incompetence and/or misconduct.  I’ve spoken with several industry executives, and all decry the silence – their employers’ silence.

We are in an election year, folks.  We are hearing about opt-out, about alternatives to workers’ comp, about a “broken system”, about how poorly you serve “claimants’ (I hate that word).

What does this mean for you?

Worker’s comp isn’t broken.  

But if you don’t get off your butt and show why, it damn sure will be.

 

 


10 thoughts on “It’s the workers’ comp industry’s fault.”

  1. Great post, disturbing graphic given recent news. I couldn’t agree more that good work is being done and the need for those who excel to share their stories-not so much to toot their own horn-but rather to demonstrate that it is possible and perhaps to shame the lazy and the greedy into improving their game.

  2. Great post, but let’s be real. CEO’s of major carriers and service providers are more intr6 in their bottom line and stock price, than doing good work.When interviewed a while back, Hillary Clinton mentioned that she asked CEO’s if they would invest in their employees if it meant a drop in their stock price. They all said no. The problem is not the adjusters, it is the cheap SOB’s at the top. So my fellow bloggers will continue to take the industry to task until the suits get it.

  3. Agree fully. There is room both for good stories about the overall role played in sustaining human potential that many in the industry do. Also perhaps some ProPublica like pieces about the lives killed or maimed by the likes of Purdue Pharma (Oxycontin), overzealous treaters, the fraudsters who are not necessarily rare that force the need for rigorous claims management and more. We all know that the trial bar is politically active and have enjoyed a ‘good guy’ image in society. The defense side is painted by them as avaricious lackeys for business.

    In the end facts matter on large scale and individual claim level.

  4. Texas Mutual has also told the positive side of the story through the eyes of the injured worker. We had a worker who was seriously injured several years ago and returned to work through his hard work and dedication, along with the support of Texas Mutual and others. Ronnie’s story was a major focus of our print, online and web marketing campaigns earlier this year.

  5. Thanks for raising the topic, Joe. There are definitely success stories out there with the power to restore faith in the industry. We\’ve been placing the injured worker and family at the center of our model since we started 25 years ago. A few have shared their experiences with us and are featured on our website, YouTube channel and other social media pages:
    http://www.paradigmcorp.com/our-impact/case-studies

  6. I truly believe there are good people with the right intentions out there. Sadly from a medical practice standpoint, we don’t always hear about them from the patients. Though, I’ve had some really great people at carriers go up and beyond not only to help the provider get paid but also assist the claimant with their claim so they can get the treatment they need.

  7. Excellent post. I am on the provider side dealing with catastrophic cases and in our experience, the carriers are genuinely trying to do the right thing while being financially responsible – we believe these are not mutually exclusive.

    Thanks for raising the point and look forward to more stories of impact being shared on the good work that is being done.

  8. Great post!

    Our TPA has improved in self-promotion of the good that our colleagues have done during the short period I have been employed by them. However, most of the self-promotion is still internal to the company, not external for public consumption.

    When I started, there were occasional inter-office emails providing an overview of specific good deeds by colleagues and a rough identification of who was singing their praises (client risk officer, claimant, claimant’s family). Now we have regular internal publication on client kudos, so we can recognize the successes of colleagues throughout the company.

    Although I feel that this aids colleague morale, it would also be appropriate to share some of these stories in a manner that helps improve our company’s and industry’s image with the general public.

  9. More needs to be done, but they need to hire experts and spend a lot of money to overturn the negative image that all Workers Compensation insurers have garnered over the years.

Comments are closed.

Joe Paduda is the principal of Health Strategy Associates

SUBSCRIBE BY EMAIL

SEARCH THIS SITE

A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

DISCLAIMER

© Joe Paduda 2024. We encourage links to any material on this page. Fair use excerpts of material written by Joe Paduda may be used with attribution to Joe Paduda, Managed Care Matters.

Note: Some material on this page may be excerpted from other sources. In such cases, copyright is retained by the respective authors of those sources.

ARCHIVES

Archives