The Workers’ Compensation State: Caterpillar or Butterfly?
By Jess Dantice, CEO, Zenjuries
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 wc 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 Rudolph’s 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 there waiting on them to emerge like hungry Grizzly bears in an Alaskan salmon river.
Problem two in the caterpillar wc system is that reporting injuries to the right people/entities immediately and directing these injured employees to the proper care providers in the best practices timeframe doesn’t happen…like ever. Workers’ compensation policies do not come with user manuals. There are no instruction pages. The only things that can be counted on being there from the beginning of an on-the-job injury is fear and frustration. When users don’t know who should be notified and when, delays happen. When users don’t know where to go for the proper initial treatment and evaluation, delays happen. When users don’t know whose responsibility it is to pay for the treatments, delays happen. When employers consider paying claims out-of-pocket because they are afraid their future rates will go up, delays happen. When questions don’t get immediate answers by these frustrated and fearful users, then delays start to stack up like the Giant Ant Hills of Zambia.
Problem three in the caterpillar wc system is the complete and utter breakdown of proper communication between all proper parties at all the proper times. When a worker becomes injured on-the-job, pressing questions begin to emerge in their minds almost immediately. Simple questions like, where do I go for treatment? Who pays the medical bills? Who pays for any medications prescribed? Will I get paid while recovering at home? How long must I be out? Will I be fired? As if all that’s not enough, simple questions in the employer’s mind start to arise as well, like should we wait to see how bad the injury is before we notify insurance? Will this injury effect our premiums next year? Should we have the employee use health insurance and then reimburse? Will we become liable if we try to be involved in making sure ongoing medical care is provided, or is that the insurance company’s job? What can we do and what can’t we do as the employer? Where’s our insurance agent in all of this? The trouble is that with most workers’ compensation claims, the insurance adjuster isn’t assigned until at least 24-72 hours post injury. This means right out of the gate there’s no immediate help coming, and most businesses and employees end up “winging it.” Making the situation even worse is the fact that once a case loaded adjuster is finally assigned, then the injured employee and this newly introduced complete stranger disappear into the darkness of the caterpillar system with little to no word on any progress. When communications start to break down and become less and less active, the claims closing process moves slower than a three toed sloth wading through a pool of peanut butter. The traditional caterpillar system is begging for a long overdue transformation, maybe even a hint of disruption.
Meet Zenjuries.com
Zenjuries, the butterfly wc system, emerged from the cocoon that was formed in the trenches of necessity at the frontlines of the workers’ compensation battlefield.
Zenjuries’ founders are veteran insurance professionals that sold and serviced the caterpillar system for decades before coming to the realization that they were stuck in the definition of insanity: doing the same thing over and over, expecting a different result. The aforementioned problem areas were fought against daily but never conquered. Business owners were mad. Injured employees were mad. Insurance agents were mad. Claims adjusters were emotionless J. Insurance companies were demonized. Attorneys were loving it! A stark realization began to set in that all the people involved in the process wanted a much different and better workers’ comp experience but didn’t know how to find it or achieve it on their own. So, Zenjuries was created to put the entire workers’ comp system on “best practices” auto pilot by using technology to drive the user’s actions and thus creating an entirely new experience and outcome. Some of the missing links have always been due to the lack of education in regard to questions about who, what, when, where, why, how, how long, and with whom the system is supposed to operate for the best potential outcome. Couple these questions with the general fact that people don’t have any extra free time in their days to commit towards learning and understanding the answers to all of these ever-present questions. The conclusion is that people will participate as long as they don’t have to commit more of their valuable time, and also if participating is easy and convenient. Zenjuries produces the much needed solutions!
Solution one is creating a team of professionals (that is already paid for and available) committed to participating together through simple communication from start to finish for each injury. One person will never be able to accomplish the positive results of a highly skilled team. Zenjuries’ application begins by leading users to create their own customized handpicked teams that will be called into action the moment an injury occurs. These teams are then prompted and instructed on exactly what to do, when to do, how to do, etc. through the entire process. The software makes sure to keep everyone looped into the system without users needing to remember their various duties. Zenjuries puts proper and timely communication in front of each user throughout the life of each injury automatically, systematically. Zenjuries butterfly system of team participation compared to the one case-loaded adjuster system results in a much better outcome physically, mentally, and financially.
Solution two is providing an easy and effortless way to report on the job injuries at any given time, from any given place. Delays in reporting injuries remains one of the costliest mistakes in the workers’ comp system. To achieve the desired results of promptly reporting every single injury, our butterfly system had to make it easy and convenient for users. Zenjuries created an injury reporting system that’s not only available on desktop software, but also available through the Zenjuries app, downloadable for free in iTunes and Google Play stores. In 60 seconds or less, a Zenjuries.com user can open the app, press a few buttons and instantly notify every person on their team of the injury details. In just a few seconds to minutes, Zenjuries completely erases lag-time reporting which creates fast proper care, better user experiences and lower claims costs.
Solution three is properly answering the who, what, when, where, why, how, how long, and with whom conundrum that every single claim presents. The secret lies within a little-known fact that has been learned at the school of hard knocks: no one has extra time, energy and resources ready to devote to learning these answers. With Zenjuries, the software does the learning for them and simply notifies each individual user only when their efforts are needed. No more out of sight, out of mind. No more delays due to poor understanding or lack in timely, pertinent communication. Our butterfly system has “best practices” algorithms prebuilt into each user’s role that individually keeps the claim on track, running smoothly and efficiently towards the best-case conclusion for every single claim. With very little effort and time commitment, each user can perform at their peak abilities which produces an incredible new and pleasant user experience and also produces a much faster closure of claims with much lower costs being associated. Easy, effortless, pleasant, frictionless, and lower costs are the hallmarks of the Zenjuries butterfly transformation from the old caterpillar workers’ compensation system.
For decades, the workers’ compensation system has been demonized by attorney advertising from coast to coast. That territory has been ceded by insurance professionals that failed to offer up any kind of rebuttal or defense. A very dim view of the system exists today as a result. Zenjuries is taking that ceded territory back one case at a time. By making it easy and enjoyable to participate, users are enlightened each time they experience the butterfly effect that Zenjuries is creating. Zenjuries is systematically transforming the old workers’ compensation system making it possible to start saving billions of dollars in overinflated and unnecessary claims costs along the way.
