Claims Shops Offer New Services to Help Businesses Reopen

By Jim Sams | April 30, 2020

As businesses begin to reopen after weeks-long closures to slow the spread of coronavirus, claims management companies have adjusted their service offerings to smooth the transition.

Sedgwick, for instance, in February began helping clients set up temperature screenings for essential workers unable to work from home. The company has also multi-tasked its nurse triage call center, which was set up to assist workers’ compensation patients, to take questions from client employees seeking treatment for COVID-19 or concerned about exposure.

Tracey Radford, a senior vice president for managed care client services, said the shift toward more proactive services was an easy pivot for an organization already focused on medical management.

“In this case it’s really about, what do we do when we don’t have a claim?” Radford said. “How can we help our clients with getting employees back to work?”

Radford said Sedgwick’s clients asked Sedgwick for help in assuring employees that employees are being kept safe from the spread of COVID-19. She said the company used its network of medical providers to source non-touch infrared thermometers for employee temperature screenings to ensure that nobody with a fever walks into the workplace.

Each screening is done by a clinician who is trained in infectious disease management, either a home health aide, licensed practice nurse of registered nurse, Sedgwick says. Clients can customize the service. Screenings can also be done remotely.

Radford said Sedgwick is also using its 24-7 on-call nurse services for injured workers to answer employees’ questions about the coronavirus. She said the service is offered to all of Sedgwick’s clients, even those that had not contracted to use the nurse triage line.

Some employers have also called on Sedgwick to help protect returning workers with physically demanding jobs who may have gotten out of shape during the pandemic shutdown. For that, Sedgwick offers a variety of instructional videos on conditioning exercises and activities.

Similarly, Radford said Sedgwick has had to keep a close eye on injured workers who have been forced to delay surgeries because of government orders that shifted hospital resources to emergency care. She said Sedgwick offers “pre-hab” physical training to ensure those injured workers are in optimal condition when elective surgeries resume.

Crawford & Co. is also offering a screening process for clients who are returning employees to the workplace. Mike Hoberman, senior vice president for business services, said the company has set up a 1-800 number that workers can call to answer a series of questions to determine if they are ready to return to duty.

He said questions include whether the worker exhibited symptoms of a COVID-19 infection and how long has it been since those symptoms subsided. Employees who are deemed fit to work according to Centers for Disease Control and Prevention guidelines are issued a certificate that clears them to return to work.

Hoberman said Crawford, like Sedgwick, is also leaning heavily on its nurse-case management team during the pandemic. He said while the company has seen a decline in some routine types of workers’ compensation claims because of stay-at-home orders, it has seen a spike in claims for the health care sector.

“Many of these health care workers are on the front end of the frontline so they are in a really traumatic situation,” Hoberman said during a video interview with Crawford & Co’s new global CEO, Rohit Verna. “We are seeing the effect of the stress really set in there.”

He said the company also continues serving injured workers who filed claims before the coronavirus outbreak who, unless critically ill, can no longer visit their doctors.

“We’ve shifted to more to of telephonic case management model, and also telehealth, telerehab,” Hoberman said. “That’s really started to gain some traction as we look for solutions to be on the front end, at the leading edge to support these injured workers.”

Crawford also offers clients disinfection services to businesses that are reopening, through a network of 700 contractors, Hoberman said.

Charles Taylor Adjusting isn’t offering any new services to help clients reopen, but it has changed the way it does things because of the pandemic, said Vince Cole, chief executive officer for the company’s U.S. operations.

Cole said Charles Taylor specializes in complex claims, so its offerings aren’t as broad as the big claims shops. The pandemic has, however, forced the company to increase the number of inspections that it does remotely.

Cole said Charles Taylor has built an application that allows its adjusters to determine the dimensions of large structures by taking photographs. He said the remote adjusting program is similar to an off-the-shelf product marketed by Hover, but designed specifically for the large, more complicated claims that Charles Taylor investigates. The company had distributed the software to all of its adjusters and third-party contractors, he said.

The pandemic hasn’t slowed down the flow of claims to Charles Taylor. Danielle Kaminski, a senior vice president, said the company is investigating several hundred business interruption claims. Many in the industry have said such claims are unlikely to be paid. Kaminski offered no opinion on that, but she said even an initial investigation, such as collecting coverage data, confirming policyholder information and taking an insured’s preliminary statement can take several hours.

Investigations for California business-interruption claims will be even more time consuming. Insurance Commissioner Ricardo Lara issued a directive prohibiting employers from issuing blanket denials.

“There has to be a fair investigation,” Kaminski said.

About the photo: Americans lined up to buy goods at supermarkets like Costco Wholesale and Walmart as fears over COVID-19 pandemic in New Jersey, on April 18, 2020. Photographer: Tayfun Coskun/Getty Images /Anadolu

About Jim Sams

Sams is editor of the Claims Journal, part of the Wells Media Group. He can be reached at jsams@wellsmedia.com.

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