Want to Launch a Successful Claims Closure Initiative? The Key Is Changing Company Culture

If you're ready to take claims closure projects to another level, the team at Kaiser Permanente will tell you how, this fall at NWCDC in Las Vegas. 
By: | July 23, 2019

Claims closure projects aren’t a simple matter, but they’re well worth the effort. By closing claims that are 20-30 years old, companies are often able to settle for less than the case reserve and save on any future incurred but not reported (IBNR) costs associated with a particular case.

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Building and sustaining an initiative, however, can be tricky. Many companies only take on claims closure initiatives for a few months after claims build up and become unmanageable.

The people behind a claims closure project at Kaiser Permanente are looking to change that mindset.

Their project, which has been running for almost four years, will be the subject of an expert panel discussion on Nov. 6 at the National Workers’ Compensation and Disability Conference in Las Vegas, at a session entitled “Launch, Sustain, and Measure a Claim-Closure Project’s Impact.”

The presentation will allow attendees to understand what has made Kaiser’s panel so successful and it will help them come up with strategies for undertaking similar projects within their own companies.

“Kaiser is just a great case study for how impactful [claims closure projects] can be,” said Esther Becker, the actuary for the project and one of the panelists for the session.

“It’s a great framework to make these points because I think people are really interested in claims closure projects,” she said.

“One of the biggest criticisms for a claims closure project is you put all of this time and effort and money into [it] … then a year or two later you’re in the same place you were and your inventory has gone back up, because no one has really learned anything,” — Martin King, director of corporate risk management, Kaiser Permanente

Martin King, director of corporate risk management at Kaiser Permanente and one of the panelists during the session, believes that changing the company’s attitude towards closing claims is part of what has made their program so successful and long lasting.

“One of the biggest criticisms for a claims closure project is you put all of this time and effort and money into this closure project and you do it for, let’s say six months or whatever, and then a year or two later you’re in the same place you were and your inventory has gone back up, because no one has really learned anything,” he said.

“All they did is go in and put their heads down, and put in a couple weekends and extra hours, and close some claims, but they didn’t change the culture of the claims shop. That’s what we’ve really done at Kaiser.”

King and Becker will be presenting alongside Debbie Ehsan, senior workers’ compensation manager at Kaiser Permanente, and Beth Dupre, managing director and national practice leader at Marsh, who helped Kaiser undertake the project.

During the panel, they will discuss how they were able to collaborate with one another and with Sedgwick, Kaiser’s TPA. Dupre believes that “selfless collaboration” between the different companies has been a key to the project’s success.

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“It feels like we’re all working together, that we are truly singularly one team. I think that really helps a lot,” she said. “We’re all one. We’re all Kaiser regardless of who our employer is.”

One of the biggest things that attendees will take away from the session is real data and stories from Kaiser’s claims closure project, which focus on how they’ve been able to keep the project going for so long.

“It’s all going to be real data. We’re willing to share our actual experience. We’re going to not sugarcoat it, so we’ll talk about the pains we go through up front, and the pains are many in number,” King said.

One key takeaway will be an explanation of how Kaiser makes estimates financially, “because it’s tricky and not many people have the actuarial support that we did to do that,” said King.

Attendees will also learn “what they can do … to make it a permanent claim closure mentality and culture in a claim shop,” he said. &

About the National Workers’ Compensation and Disability Conference® & Expo:

As the largest National Workers’ Comp and Disability Conference for more than 25 years, NWCDC offers endless opportunities that will propel your workers’ comp and disability management programs forward.  With the biggest Expo in the industry, you’ll be able to touch, compare and contrast the newest solutions from leading vendors in every category, and gain knowledge on-the-go at in-depth sponsored sessions on the show floor. Additionally, NWCDC offers valuable networking opportunities so you can make important contacts and share strategies with your peers.

You can also customize your learning experience with breakout sessions in six distinct program tracks: Claims Management, Medical Management, Program Management, Disability Management, Legal/Regulatory, and Technology. Plus, you’ll hear from Risk & Insurance’s Teddy Award winners for excellence in lowering workers’ comp risk.

Learn more about NWCDC and special savings for Risk & Insurance® subscribers here.

Courtney DuChene is a staff writer at Risk & Insurance. She can be reached at [email protected]

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The R&I Editorial Team can be reached at [email protected]