Workers Compensation Agents, Clients and Insurance Companies – Winning the Trifecta of Communication

Ok, maybe I’m the first to compare the workers compensation product and it’s distribution system with a horse race, or maybe not! But when it comes down to managing a workers comp program, selling a policy, renewing an existing policy or helping a client with a code or audit problem it’s communication that jumps into the lead. So let’s talk about a winning formula for agents, employer clients and insurance companies.

I’d venture to say that a great deal of consulting cases that we are asked to work on have their beginnings in a failure of communication. In this context when I say a failure of communication I really mean that there has been some kind of major break down between the parties involved. To begin you must understand that what we do isn’t really rocket science. So when things fall apart during an audit dispute or dispute over the use of a specific code on a policy you must consider the parties involved and their individual points of view. Here’s a few points we come across with some frequency..

An Insured Policyholder, Employer or Clients point of view:

  • The insurance company is only interested in charging me more premium –
  • If I don’t cooperate with the audit it will be better for me –
  • If I hold back information they won’t know what I really do –
  • If they know what I really do they will charge me more –
  • I’ve given the insurance company all the information they need and they still ask for more –
  • It’s none of the insurance companies business what’s on my financial statements, I won’t show them or give them a copy –
  • I’ve already given them what they asked for –
  • They reclassified my employees, the insurance company must be wrong –
  • I looked up the code the insurance company used and that’s not what we do –
  • Nothing has changed, I can’t possibly owe them that additional audit premium –

An Insurance Company point of view:

  • It’s our job to discover all possible additional premium sources –
  • Our auditors don’t make mistakes –
  • How we interpret the rules is all that counts –
  • We can do whatever we want at audit –
  • Policyholders are usually uncooperative at audit –
  • We can reclassify or move payroll anytime –
  • The policyholder did not provide us with the requested information –
  • The policyholder did not respond to our request to perform an audit –
  • We have the right to look at and request any documents we want –

An Agents point of view:

  • I wish I could get my client to understand how the audit process works –
  • The insurance company was wrong –
  • The client was wrong –
  • The auditor made a mistake –
  • I wish the insurance company would be more understanding of my clients problem –
  • I don’t understand where the mistake was made –
  • I need to be involved so I don’t lose my client –
  • If a mistake is made my client may go somewhere else –
  • All I want to do is get my client and the insurance company together so they can come to an understanding and get past this problem –

Anything here sound familiar? If you have children, you get the point! Bridging the communication gap can be a challenge. I’ve learned from experience that most of the points mentioned above are actually false in reality but exist only in perception. And when money (premium) is involved people and companies do some strange things!

Here’s a few things I’ve discovered that lead to a winning combination:

  • Most people (clients, policyholders, insurance carriers and insurance agents) really want to do things right. They really do care about having errors corrected and mistakes discovered.
  • Misconceptions and perceived errors usually come from a lack of understanding and when presented with factual information, go away.
  • Motivation for each party involved comes from a different place.
  • Education about the product for all parties involved is a must!
  • Understandable communication must be present.

While it may be natural for a policyholder to be suspicious of the motives of an insurance company it’s their agents job to be the buffer and to educate the client about the way the audit process and classification code assignment works. It’s the insurance carriers job to follow the rules, as outlined by the governing authority, and to recognize and apply proper corrections to discovered errors and mistakes. It’s the clients job to be cooperative and forthcoming about the work process and operations they conduct and to learn about and understand the rules, how they apply to their specific situation and to ask for help when they are confused or need more information!

So win the Trifecta! Take the time to learn about the workers compensation product and perfect your communication skills. And if you are a policyholder, agent or broker or an insurance company underwriter or auditor and need help with a workers compensation audit or code problem, be sure to contact a workers compensation consultant for help!

Hope this help you out! Thanks!