How Employers Can Minimize Workers’ Comp Claims Pitfalls

October 24, 2025

Since claim outcomes affect employers financially, Human Resources teams must stay engaged, ideally in partnership with their insurance broker, to help drive better results. This article highlights best practices in WC claims communication and handling, along with practical tips on how to set your team up for success.

The Key Role of Personal Communication

Technology and email templates have improved communication and streamlined processes for claims adjusters by reducing their administrative workload. However, the use of AI and automated, legal-heavy boilerplate messages can come across as confusing, impersonal, and frustrating for both injured workers and employers.

While written communication is both necessary and often legally required, relying too heavily on it without balancing it with live discussion, clear and simple explanations, active listening, and empathy can erode personal relationships and reduce trust in the process. WC claims bring uncertainty, and when that uncertainty isn’t properly explained or put into plain language, it can heighten stress, anxiety, and doubt for both the worker and the employer.

This breakdown in communication can lead injured employees to hire attorneys, which increases claim costs. Additionally, employers may lose faith in the adjuster’s capabilities and respond by micromanaging the process, which adds pressure on adjusters and can lead to burnout and staff turnover.

Personal Touch Point

A helpful practice is for employers to ask adjusters to personally call injured workers—introducing themselves, explaining the benefits, and preparing them for any official notices. This can ease the worker’s anxiety and clarify the process.

In the business world, a 24-hour response time is generally standard, with faster replies expected for time-sensitive matters. That said, urgency is often subjective. To assess whether an issue truly requires immediate attention, adjusters will evaluate if the situation poses a risk of harm or significant negative outcomes. For example, an injured worker showing signs of infection or expressing suicidal thoughts would require immediate action. Time-sensitive legal events, like an upcoming hearing or deposition within a week, may be considered urgent. In contrast, routine matters like getting approval for physical therapy don’t fall into the urgent category.

HR professionals can smooth communication expectations by helping distinguish urgent from non-urgent concerns and reassuring injured workers that their needs are being addressed. Clear and detailed communication from both injured workers and employers also helps adjusters fully understand the situation and take timely, appropriate action.

Another key pain point is when adjusters fail to respond to status update requests, whether about disability payments, treatment approvals, or work restrictions. Sometimes, adjusters delay replies because they’re still waiting on information. Employers can request that adjusters provide a quick response explaining what they’re doing to get the information and when they expect to have it.

Promoting Proactive Follow-Through

A well-crafted action plan is meaningless without proactive follow-through. A common frustration arises during claim reviews when it becomes apparent that the adjuster is simply going through the motions, repeating the same status and action plan presented in the previous meeting months earlier, with no explanation for the lack of progress. This can feel like déjà vu or being stuck in a loop.

Here are a few scenarios where adjusters may fall short in following through:

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