Legacy Closures: What to Expect From Outside Experts

Managers already using outside attorneys and consultants to help with workers’ comp legacy claim closures and those considering retaining such assistance should understand what these experts bring to the table and how to use them effectively.

Even if your internal team has deep knowledge of your current claims, the objective and non-emotional assessment of an outside expert often can help move even the most difficult cases toward closure. In addition, their base knowledge on how to structure the overall process can help avoid obstacles or delays and achieve optimal results.

Workers’ comp claims closure initiatives typically begin with a review of your claims inventory. Open claims should be sorted based on such factors as:

• age of claim;

• past and projected claim cost;

• complexity, including the existence of comorbidities, such as obesity and diabetes, as well as use of opioids in treatment; and

• jurisdiction

Work with your internal team or engage consultants to review your inventory (stratified by incurred), and evaluate past and current closure results. Based on experience, outside experts can provide insights to help you to establish clear objectives for reducing open claims and overall costs within defined time periods.

In working with outside consultants and attorneys, consider the following practices that have helped drive performance:

Share financial details

Claims consultants and attorneys can develop and implement strategies to meet your objectives.  However, by sharing financial information – albeit discretely – you help them establish priorities that are better aligned with those of your team.  For example, you may want to share such information with the lead attorney contact at each law firm you engage so they can assign specific cases to achieve optimal results.

Be strategic in your selection process  

Organizations with claims in multiple jurisdictions may be drawn to use a network of attorneys and consultants who offer local expertise. While this approach may have advantages in certain difficult jurisdictions, it generally poses management challenges. Many organizations with claims in multiple jurisdictions have reduced costs, improved and accelerated results by consolidating external resources and selecting law firms and other providers whose geographic footprint best matches their overall needs.

Check references

In cases where the performance of consultants and law firms on closure projects was underwhelming, the shortcomings often are traceable to consistent failures in the hiring process to fully vet the firms. So, taking the time to get references is well worth the effort.

Start with a pilot

Some organizations have been able to identify best practices and establish protocols for working effectively with outside providers by beginning any closure initiative with a pilot involving a few jurisdictions or a select number of complex claims.

Track progress

Many consultants bring technology and advanced claims-tracking capabilities that capture all relevant information and provide scheduled and actionable reporting.  This gives you the ability to constantly monitor results against objectives and make critical decisions along the way to maintain momentum and drive performance.

Maintain communication flow

Top-performing organizations have regular conference calls and phone discussions with all their providers.

As you track performance, share results with all members of your team — including both internal and external resources. Stay on top of progress and obstacles on difficult claims and understand what strategies are being used to address them.Be specific in your instructions or inquiries and hold providers and attorneys accountable for responding promptly and keeping you fully informed of all significant developments.

Don’t overlook other advantages of outside help  

While not always anticipated at the outset of an engagement, other benefits from outside resources can include identification of opportunities to improve claim-legal processes, as well as to provide better legal panel guidance and enhance existing partnerships, all of which can translate to effective cost management and improved outcomes.

Outside consultants and attorneys offer extensive experience and specialized expertise that can help managers achieve and exceed their claim closure objectives. By selecting providers that best meet their needs, communicating effectively, tracking progress and sharing results, managers can receive the optimum benefits from these valuable relationships.