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» Learn and Prosper from Claims Advocacy’s Top 3 Building Blocks

March 2, 2019

Insurance Claims

The claims world of any business can be overwhelming. Whether big or small, increasing financial demands and more regulations than ever can cause many to wonder who’s actually on their side.

While it’s been proven using an advocacy-based model for workers compensation is successful in reducing attorney involvement, improving medical outcomes and speeding return to work, the fundamentals behind the why and when of the approach often remains unanswered. Without understanding the basics of claims advocacy, a business owner’s willingness to take a more active role can be derailed.

But, if your broker builds a foundation on the top three building blocks of claims advocacy, the process can be simplified for clear solutions and the best outcomes, according to Chicago-based Presidio Property & Casualty Claims Director Bill Wojcik. “Claims advocacy planning allows us and our clients to have a road map in hand so when the unexpected does occur, we can use our collective experiences to provide the knowledge they need before they know they need it,” he explains.

Power of Three

At its core, an advocacy-based claims model can empower the employer and injured worker at any point during the claims process. To harness this power, Wojcik and his team at Presidio focus on the knowledge behind the power of three:

1. Know the coverage addition changes.

Most property insurance policies contain sections with titles including “Additional Coverages” and “Coverage Extensions.” While “additions” and “extensions” imply the policy is broadened, it shouldn’t be assumed the coverage and/or limit satisfies the insured organization’s needs.

Transparency up front is the key to understanding a policy’s protection, according to Wojcik. “We try to give the client as much information as they can digest. There are a lot of variables and each type of claim has its own script to verify coverage and loss as defined by the policy,” he states. “For instance, if it’s a worker’s compensation claim we try to get the client and his employee as much information as possible. We provide the answers to know if it’s a compensable accident, and if prescriptions will be covered and transportation will be taken care of for appointments — we know all of the questions that most don’t know to ask.

“The best outcome is we’ve got the worker back to light duty or at an alternative employer to avoid a lost time claim by getting them active, involved and on the road to recovery,” explains Wojcik. “They’re investing in themselves, which long term cuts costs for our clients.”

2. Know the process.

Did you know that many claims advocates may have never handled a claim from the carrier side? Asking if your advocate has worked with both the carrier side or served in carrier manager roles can help determine how much they understand claims advocacy as a whole. “Knowing how the process works is invaluable for complete advocacy,” states Wojcik, whose team at Presidio represents the big picture of experience. “We differentiate ourselves from others in that we look at the claim from the outside with fresh eyes—one that sees both points of view.”

Claims advocacy experts at Presidio define broad experience. The Chicago agency’s over 200 years of experience represents authority in property and liability claims, in addition to executive claims. “Our clients range from mom-and- pop grocers, up to diversified holding companies,” states Wojcik.

Wojcik also credits Presidio’s partnership with Acrisure— one of the top 10 largest insurance brokers in the world—for the ability to customize a claims advocacy approach to find the best solution for each client.

“We’ve got a network of thousands from across the country at our fingertips,” he says. “It’s the difference between being in an office that is an insulated island of 12 or 15 people opposed to a group of over 2,000 experts with a vast array of experience, which allows us to provide answers and solutions.”

3. Know the issues.

Being knowledgeable on the current case law and its applicability to a claim is essential to advocating for injured workers. “Your claims advocate should know how and where the issues arise and how to get through, around or over them,” Wojcik explains. “Our obvious responsibility is to the policy holder, our client, and we’re going to advocate on their behalf. But, we have to be able to see the situation in its entirety and explain why a claim may not go the way they want, and give them the reason behind it.”

Proactive small fixes can help avoid the legal issues involved with many claims, and ultimately save thousands of dollars. “Whether it’s new business or a renewal, we do a quick claim review to understand the company’s trends and how we can improve results,” says Wojcik. “Little things like being aware of trip hazards and educating on proper lifting can save up to $40,000—money that can buy a part-time employee and increase their productivity.”

Presidio’s preparation and dedication to their clients throughout the claims advocacy process makes the difference, according to Wojcik. “By having a plan in place and the tools available to them, our clients know we’re their trusted advocate.”

If you have questions about claims advocacy, ask us. Presidio’s innovative mix of intellectual strength is prepared to provide answers to meet your needs, challenges and expectations.

Posted by in Insurance Claims