Protecting Insurance Employees from What’s Inside the File

Insurance companies play a crucial role in providing financial protection and support to individuals and businesses in their time of need. When it comes to handling claims for catastrophic injuries or death, they must also ensure that their employees are properly trained and prepared to not only provide support throughout the various situations they will encounter over the course of their career, but to do so while also protecting themselves.

Complex and catastrophic claims often contain graphic photos and descriptions of what happened. And, unfortunately, these claim files aren’t marked to provide any kind of warning of their contents.

Are claims professionals prepared for what they may encounter within this type of claim? In recent years, there has been a growing focus on employee mental health, with some companies recognizing the toll that handling stressful claims can take on individuals.

Providing proper training in how to handle such claims, ensuring the assigning of complex claims to more senior employees, and making available resources to those who may be affected by the contents of the file are the first steps to ensuring their mental well-being.

Jennifer Cogbill

With the focus on employee mental health becoming more prominent in recent years, especially in the wake of COVID-19 and the associated mental health awareness campaigns, many companies have made mental health resources available for employees.

Many insurance claims employees who deal with stressful situations on a daily basis may face burnout and emotional distress—and coming at a time when there are shortages of trained professionals in the industry places more strain on the system. Providing access to mental health resources through the human resources department can help employees remain engaged and seek help when needed.

However, despite these efforts, there are areas where organizations may fall short.

One common shortcoming is the improper segmentation of claims. Since claims are often handled by various team members, exposure to sensitive photos and other claims materials contained within the file can happen across the team, and not always with those properly trained and/or prepared. When an employee who hasn’t received the proper training is exposed to a complex or catastrophic injury claim, it can have adverse mental or emotional effects.

Organizations may also be overly focused on the investigative and administrative aspects of the claim, neglecting the human toll it takes on their employees. This can lead to a lack of support for the employee who may be struggling with the mental aspect of handling these types of difficult situations.

Companies should have a plan or team in place to discuss the impact on employees in the event they are adversely affected. This includes assigning claims to employees based on their level of expertise and providing resources to assist in all aspects of the claim. Good leaders should be open and up front about the emotional distress that may arise from handling claims and watch for any signs of distress in their employees. Human Resources should also play a role in providing accessible and confidential mental health resources.

Employers can put various services in place to support their teams. Promoting relationships within the team can enable conversations about difficult claims and situations, fostering a supportive environment. Leadership can also proactively reach out to their staff for check-ins and ensure they are aware of the resources available to them. Employee Assistance Programs can provide additional support and promote a culture that encourages utilization without judgment or fear.

Those companies that promote support for employees as they navigate catastrophic claims often offer specialized training for those who handle the most severe liability claims. This training focuses on both administrative excellence and support for the employees engaged in those claims.

The focus on mental health should be a wider trend in the insurance industry. While May is mental health awareness month, it should be emphasized throughout the year. It is critical for employers to go beyond simply providing resources and to actively engage with their employees to ensure they are ready to handle tough cases and have the necessary support. Identifying employees’ strengths and preferences can also help in assigning them to claims that align with their skills and comfort levels.

For those insurance companies that are taking steps to prepare their employees for the various situations they may encounter in claims handling through training, assigning claims based on expertise, and providing mental health resources, keep up the excellent work.

Cogbill is a senior vice president, GBCARE, Managed Care Advisor Group at Gallagher Bassett.