We talk to injured workers every day who have had much needed medication, therapy, or even surgery denied. To many claimants it must seem like their health is taking a back seat to insurance company profits. However, it may be that insurance companies are putting their own financial health at risk by not focusing more on providing great medical care. 

Joseph Paduda over at InsuranceThoughtLeadership.com recently wrote a compelling article essentially stating that insurance carriers are throwing away money by focusing on reducing short term medical costs at the expense of the injured worker’s long term health. Instead, Paduda argues, carriers should be focusing on providing high quality medical care and disability management. Some insurance company employees, with no medical background, frequently deny or delay treatment requested by experienced doctors. Since workers’ comp insurance carriers view medical costs as an expense to be avoided instead of part of the process of returning an injured worker to health – and hopefully employment – these denials are too often encouraged. This all leads to years of lost time benefits and medical expenses that might otherwise have been avoided if the injured worker had received the treatment he needed, when he needed it.

“they think it is providing financial protection from industrial accidents, when in reality it is preventing losses and delivering quality medical care designed to return injured workers to maximum function.”

So what should insurance companies be doing to improve service, and their bottom line?

• Encourage a larger doctor network by making it less cumbersome to bill and request treatment.
• Utilize medical experts, not just actuaries, and put them in positions of authority.
• Change the focus from short-term cost savings to long-term disability management.