I believe it was the wise philosopher Abraham Jebediah “Abe” Simpson II, better known as Grampa Simpson from Fox’s “The Simpsons,” who I first heard utter this phrase. In his case, he was assuming someone who was actually trying to help him was working against his best interests. In some cases, we experience that same culture when it comes to businesses and their property casualty claim management approach. They believe their adjusters and injured employees are their adversaries.

Often those who feel this way have similar relationships with their other partner vendors. It’s them against the world. If so, is this a result or a symptom?

What is the claim management culture of a business? How quickly are claims reported — specifically workers’ compensation claims? The longer it takes, on average, the higher the cost.

Do businesses hide or self-pay employee injury claims? Besides the loss of the ability for medical bill reductions and the potential for Medicare set-aside notice penalties, the actual amount of positive impact on one’s mod is much less than assumed.

What type of a return-to-work program does the business have? Do they view injured employees as the enemy and ignore them, or do they frequently engage and pro-actively review aggressive and useful light duty options to get the employee back to meaningful work as soon as possible?

There are various ways to approach such a challenge. First, find out how did this culture develop? Chances are high that it was a bad experience. Twenty-plus years in the industry would tell me it was the result of poor communication.  Either the adjuster didn’t communicate well enough regarding a sensitive coverage or evaluation decision, or they didn’t communicate at all. Perhaps an injured employee gloated about a claim settlement or was believed to be doing activities outside of work they were allegedly not able to perform at work.

We believe the best strategy — and a must for best results — is to approach claims and losses together as a team. Holmes Murphy’s goal is to help build such a process and attitude between the client, their carrier, and us.

We understand there are situations where an adjuster may not be providing the best in service or insight, or employees are exploiting the system. In those cases, we need to jump in and assist.

However, there are better approaches then Grampa Simpson’s to gain best outcomes and results.