Protecting the Claims Adjuster: A 60-Second Seminar in Workers’ Compensation Claims Handling

Even though many examiners work remotely on a full-time basis, they are still under the threat that an irate and potentially violent injured worker might become aware of their day-to-day whereabouts. Not only does this make the examiner fearful for their personal safety but also for that of their family and co-workers. Memories of a mass shooting at an insurance company in San Francisco come to mind, where a gunman killed two employees and injured eight others. That incident forever changed industry procedures as to access to a claims department.

For those claim’s operations that have returned to a traditional office environment, most have implemented security protocols for the protection of their employees; however, many of these very same companies only provide building security but offer minimal protection at the end of the day when employees openly leave the building, typically walking freely to their vehicles in an unmonitored auto-parking area.

Concern over safety is not limited to claims adjusters.  Many attorneys, both from the applicant and defense bar, have expressed a fear of being attacked by angry applicant. Who can ever forget the instance when an applicant attorney was murdered in his office by an angry client or the time when a defense attorney was assaulted by an applicant wielding a hammer?

Workers’ compensation judges have also expressed a concern over safety as they often order State Police or California Highway Patrol Officers to be present when certain cases care scheduled for hearing.  In addition, employers appearing at the WCAB are sometimes accompanied by their own security personnel.  Unfortunately, violence at the WCAB was brought to a forefront when a workers’ comp defense attorney was stabbed in the back at the Los Angeles Board.  The assailant was seeking revenge against a Judge who had earlier denied his appeal when he happened upon a defense lawyer and changed the object of his ire.

With all that said, we submit that claims administrators should assess their existing safety policies. For the protection of all, we suggest that they eliminate the practice of identifying claims adjusters by their full legal name. Why not follow the example demonstrated by the California Department of Insurance or the Internal Revenue Service which identify employees using numbers, such a N-4310, or by first name only followed by a number (i.e., Mary 23)?  Using a pseudonym is perfectly legal in California, if not done for fraudulent purposes or to deliberately misrepresent facts.  In the workers’ compensation context, the regulations do not require use of an adjuster’s full legal name, nor do they prohibit use of a pseudonym.

For those claims managers who believe that protecting the identity of a claim adjuster is not a big issue, we urge them to interview their claims staff and listen to what they are told. In doing so, management should keep in mind the examiner who was shot in her own driveway after returning home at the end of the workday. The assailant, having been provided with the adjuster’s full legal name on numerous pieces of correspondence from the insurance company, was able to research her home address, and lie in wait.

If you have any concerns about security issues and the legalities thereof, please feel free to contact F+B for guidance.