Workers’ Comp Power Broker Carol Ungaretti on How She Helps Clients Identify Opportunities in Their Programs

Workers’ compensation is an ever-evolving industry, ripe for innovation and testing out new ideas — and all with the goal of keeping workers safe and helping them in the event that they are hurt on the job.

With so many facets to explore, Risk & Insurance turned to some of the top brokers in the space to gain insight into what’s new in the industry and what it is about workers’ comp that just makes it stick for these professionals.

Carol Ungaretti, managing consultant, U.S. casualty claims consulting, global risk consulting at Aon, is one such professional. She was recognized as a 2023 Workers’ Compensation Power Broker for being an innovative partner that clients can lean on for customized solutions to their programs’ challenges.

Below, Ungaretti shares how she works with clients to identify opportunities in their workers’ comp programs and go beyond protocols and practices that are quickly becoming outdated.

Risk & Insurance: Thank you for taking time to share your experience with us. How has record-level inflation influenced workers’ comp over the past year?

Carol Ungaretti: While there are some protections against inflation in workers’ compensation, specifically medical fee schedules, the most apparent inflation-driven impact is demonstrated in labor shortages and increased costs to deliver claims management services, including litigation and managed care services.

This is exhibited in increased hourly rates for legal counsel, nurse case management and other vendor services crucial to the adjudication of workers’ compensation claims. The disruption related to staffing shortages can increase the time to resolve a claim, thus resulting in greater ultimate loss costs.

R&I: In your Power Broker narrative, you mentioned the work you do to help your clients avoid getting entrenched in dated workers’ comp protocols and practices. Could you share some examples with us?  

CU: I work with clients and their data to identify opportunities and drive custom claims management solutions that many times challenge some of our tightly held “traditional” workers’ compensation metrics and believed best practices.

Medical network penetration, meaning the percentage of medical treatment with network providers versus out-of-network, is a regularly used metric to grade an employer’s claims program.

I try to switch the scenario around and help clients look at key indicators tied to medical provider outcomes, including average number of prescriptions, average treatment duration, litigation rates, lost time days and other metrics that drive claim costs.

The focus is on identifying occupational providers that appropriately treat injured employees versus assuming a high in-network penetration rate equals advantageous medical outcomes.

Another example is challenging the standard IME process. An assumed objective to the Independent Medical Evaluation is to advance the resolution of a claim by obtaining an opinion from a non-treating medical authority.

Partnering with several of my largest clients, we have found that neutral to negative IME outcomes are much more prevalent than expected. By identifying the unintended cost drivers, we have designed practices to maximize the IME outcome, while at the same time “humanizing” the process for the injured employee.

Report lag time is a metric regularly used to demonstrate the performance of a claims program. While we would never discourage practices related to early claims reporting, it’s really important to look at cost drivers tied to late-reported claims with the emphasis on developing custom claims management practices aimed at identifying the risk criteria for workers’ compensation claims that result in a higher overall claim cost. This is a more actionable approach to addressing report lag time.

R&I: As many pandemic-related practices and policies continue to relax, how is COVID still lingering in workers’ comp?

CU: Retaining and recruiting adjusters has always been challenging. We anticipate feeling the impact of the labor shortage following the Great Resignation for some time.

I believe the current labor shortage will force greater attention to smarter and more efficient claims adjudication practices. Better utilization of technology and elimination of work that does not benefit the claim outcome will bring some exciting new technologies and practices to workers’ compensation.

R&I: How has accounting for the biopsychosocial factors that influence an injured worker’s recovery changed the workers’ comp landscape in recent years?

CU: It’s highlighted the human element of workers’ compensation that we regularly lose sight of.

I worked closely with clients, their claims administrators and medical providers to build solutions that use data to identify negative perceptions, behaviors and predicaments so we can preemptively target these claims and better support the injured worker.

It’s encouraging to see greater emphasis placed on the biopsychosocial component in the claims management process.

R&I: What do you think is the top technology challenge impacting workers’ comp programs right now? 

CU: The biggest challenge might be meeting our expectations as we look to rapidly advancing technologies to drastically streamline many aspects of the claims administration process. Insurers and claims administrators will be tested as they implement machine learning across all facets of the adjudication process.

R&I: What would you say is the primary dilemma clients are looking to resolve when they come to you these days?

CU: Outside of partnership aimed at reducing the frequency and severity of claims, a very real and current dilemma is adjuster turnover and labor shortages directly affecting the overall management and resolution of claims.

In collaboration with our clients and their administrators, we are working to simplify or eliminate tasks that are not considered critical or impactful to the resolution of the claim, with a goal of driving additional capacity within the adjusting team to focus on custom cost mitigation practices critical to our clients’ programs.

It’s very important right now for clients to work collaboratively with their claims administrators and support practices aimed at reducing caseloads and streamlining workflows. &