The Workers' Compensation State: Caterpillar or Butterfly?


* Funny how things change, isn't it? One day you're making sure your horses have newly shod hoofs for the two-day carriage ride to the neighboring town, and the next you're online bidding for a chance to become the first civilian to ride a rocket ship around the moon and back. Today's world is transforming so quickly that it's tempting to try never blinking again for fear of missing something rather important. Workers' compensation is no stranger to this transformation age. In fact, it's one of the most targeted markets by Insuretech firms around the globe. Why? Workers' comp is getting old. Since its inception many moons ago, a lot has changed in both our places of work and in our workers alike. But, not a lot has changed in the workers' comp process before, during, and after an on-the-job injury occurs.

The traditional workers' compensation system is stuck in the caterpillar state of functionality. We can agree that there are many different sizes, shapes, and colors to these caterpillars, but they're still just caterpillars none the less. It's frustrating. It's confusing. It's borderline intolerable. There are three major problem areas in the traditional workers' compensation system that haven't changed in over a century thus producing the system's caterpillar effect:

  1. Case Loaded Adjusters Purely Working the Numbers

  2. Failure to Promptly Report Injuries

  3. Education, Communication Breakdown

These problem areas drive the user experience of workers' compensation down the worm holes of delay and despair, ultimately wasting billions of dollars along the way. Here's how...

Problem one in the caterpillar we system is that assigning case loaded adjusters to injured employees is still the normal mode of operation for workers' comp insurance companies, TPAs, SIGs and Captives. "Case loaded" means that each adjuster is expected to have the capacity to work on anywhere from 70 claims up to 300+ claims on any given day. Pointing out that one person working on that many claims per day being impossible is like pointing out that Rudolphs nose glows bright red. It's obvious, and what ends up occurring is that the worst cases get the preferential treatment out of necessity due to severity. They also get the lion's share of time and attention each passing day. The glaring issue is that 99% of other injuries not being attended to would also like to feel important and get some undivided attention. When their needs don't get met, the attorneys are sitting...

To continue reading