How Self-insured Businesses Can Curb the Cost of Claims in a Volatile Economy [Infographic]
As significant economic headwinds usher in a new era of risk, self-insured businesses have legitimate concerns about how to keep the cost of claims in check. Challenged by inflationary pressures, an evolving labor market and the rising expense to deliver and procure goods and services, they increasingly rely on third-party administrators (TPAs) to successfully navigate the growing complexity of claim management.
At Constitution State Services (CSS), we’re not just talking about these challenges – we’re trusted partners, offering the stability, expertise and experience your company needs to stay ahead of adverse economic trends. Our proven claims methodology brings together dedicated professionals, proprietary technology and data analytics to help achieve optimal outcomes, protecting your business’s bottom line and reputation.
In this article, we’ll examine some of the challenges organizations face in our current economic climate, as well as the innovative ways CSS works with our customers to help contain costs and mitigate the impact of claims.
Social Inflation Adds to Escalating Legal Costs
- Social inflation emerged before the pandemic as public sentiment changed with respect to corporate responsibility and the value of money. Many people now hold corporations broadly responsible, whether fair or not, and they are more willing to award increasingly large sums. Plaintiff attorneys today increasingly seek to capitalize on the shift in public opinion and aggressively pursue personal injury suits and larger settlements.
- In these litigious times, CSS provides the right resources at the right time to help businesses fight back. Our power is in our people—a dedicated team of nurses, trial-ready attorneys and field-based fraud investigators, assisted by state-of-the-art technology and proven strategies to defend against inflated claims and mitigate the impact of a lawsuit.
- Much of our success can be attributed to the way we utilize nurses who team up with CSS Claim professionals to assess medical causation and facilitate the claim resolution process. Whether general liability, automobile or workers compensation claims, our medical experts review every case carefully to determine causality, scope of injury and the appropriateness of treatment, then collaborate with claim managers, legal counsel and fraud investigators to help contain costs and improve outcomes.
Alleviating the Pain
- The changing nature of workers comp claims in the post-pandemic workplace. Businesses today are up against significant human capital management challenges in the wake of the Great Resignation and Great Retaliation. As millennials rapidly replace retiring baby boomers and opportunity-seeking job hoppers, pressure on tenured staff and employers to adapt to this fledgling labor market’s expectations about corporate culture and workplace norms is mounting – and failure to adequately manage the risk can have a significant impact.
- First-year workers between the ages of 20 and 35 not only disproportionately represent the majority of today’s workforce, they disproportionally account for the majority of workers comp claims.1 The potential to have more injured workers out concurrently places added stress on remaining employees to keep up with productivity demands. Tenured staff are hit even harder, tasked to fulfill their normal roles while taking on greater responsibility to support and train their greener colleagues. Meanwhile, workers at all levels are increasingly expected to keep pace with technological advances.
First-year employees have the highest workers comp claim frequency.1
83% of tenured employees have taken on six or more new tasks in the last two years.2
~40% of injured employees lose time from work due to psychosocial risk factors.3
- The struggle is real, creating a model that is not only potentially unsustainable and unsafe in the long run, but is already starting to take its toll. Psychosocial stressors, from general anxiety to pain catastrophizing, are more prevalent and having a more profound effect on the severity of claims than ever. Oftentimes, when one or more of these factors are present in a case, higher indemnity costs and longer return-to-work times are reported.4
- At CSS, we understand that getting injured employees back to work as soon as medically appropriate is essential to keeping your business running smoothly. Our proven approach combines personalized outreach to engage at-risk employees throughout the claims process with proactive litigation management and cost containment strategies. From our 24/7 nurse triage hotline to our industry-specialized investigative services, we offer the resources you need to help optimize workers comp claim outcomes.
As an affiliate company of Travelers, a provider that writes workers compensation for the largest eligible percentage of U.S. payroll at $553 billion across 8 million workers, CSS gets proven results:
- 2/3 of injured employees return to work within 30 days, reducing turnover and protecting your reputation in a competitive market.5
- $2.4+ billion in annual savings achieved through medical cost containment strategies.5
- Our innovative CustomCareSM claims process improves the claims experience by balancing digital self-service and human connection.
Protect Your Reputation
- Meeting expectations amid shifting attitudes about corporate culture. Workers today are more engaged than ever in pushing for fair wages, more on-the-job support, comprehensive benefits and greater, genuine care for their physical and mental health. Often, when they don’t get what they want, they speak out and seek new employment.
47.2% National average rate of employee turnover in 2021.6
57% Increase in union petitions from October 2021 to March 2022.7
- Since the pandemic, employee turnover has hit an all-time high and activism is on the rise. With growing expectations for companies to prioritize employee well-being, success relies on ensuring that your people feel safe, supported and satisfied in the work they do, everywhere they do it. C-suite executives who understand this make managing workforce risk a priority.
- In addition to industry-leading claim management, CSS offers available risk control solutions powered by advanced data analysis tools and experienced loss prevention consultants. With data analytics and knowledge about our customers’ unique operational environments, CSS can offer targeted services and training resources for effective workplace risk management. Our consultants are also available to provide ergonomic assessments and identify workplace hazards, helping to keep your employees able and motivated to show up and do their best work.
Curb the Costs
- Distracted driving and the impact of inflation on automobile claims. In the wake of the pandemic, employees find themselves increasingly pressed to balance life’s personal and work demands. In fact, not only do they feel compelled to answer work-related calls on the road, they are increasingly expected to. Not surprisingly, all this distracted driving means more accidents.
24% of drivers respond to work-related calls, email or texts.8
2 in 5 managers expect employees to answer work calls while driving.8
27% of managers say an employee has had a distraction-related crash on company time.8
- Auto liability claims can be a huge expense for employers, even under normal circumstances. But in this day and age when supply chain issues and economic inflation mean longer repair times and higher costs, knowing where to turn for help can make all the difference in your efforts to minimize the impact of job-related car crashes and accidents.
- CSS connects our customers with business, medical and legal experts who can help transfer risk and minimize the frequency and severity of auto claims. When accidents happen, we provide strategic, data-driven solutions designed to achieve efficient, cost-effective outcomes—giving our customers a competitive edge with unparalleled scale, specialization and support.
The CSS Approach and Advantage to Claim Management
Powered by industry-leading expertise, state-of-the-art technology, a people-first philosophy and a data-driven approach, Constitution State Services (CSS) consistently delivers strategic claim management solutions that are engineered to achieve optimal outcomes for our customers. From claim intake to resolution, we deploy the right resources for the right claim at the right time.
Data-driven analysis helps predict the likelihood of attorney involvement, proactively identifies cost containment opportunities and sets realistic expectations for customers and claimants
Industry-specialized medical professionals, field investigators and forensics experts detect fraudulent claims and assist legal counsel
Partnership with medical billing, life care planning, radiology and legal experts provides a comprehensive, unbiased view of issues and opportunities
Localized Spanish-speaking Claim professionals and case managers bridge language barriers
Our solutions are designed to help ensure that injured employees receive the best, medically appropriate care while controlling cost and lost time.
24/7 Nurse Triage Hotline
A single point of contact for early intervention and access to medical advice throughout the claim process
Over 60,000+ in-network pharmacies supplying free, immediate “first-fill” prescriptions, plus targeted medical authorization and directed interventions
Telehealth & Telemedicine
Providing immediate, 24/7 access to the right level of quality care from medical staff who understand workers comp
Medical Network Strategy
Strong partnerships with preferred providers, concierge nurses, certified managed care networks and a focus on the future of medical interventions
$160M+ in medical bill savings for SMART members in 20201
69% average return to work within 30 days2
15% reduction in total payout when using Nurse Triage3
2-day average decrease in claim lag time reported 6 months out4
Our proven GL claim model combines data analysis, technology and litigation expertise to avoid trial or provide a vigorous defense should a claim advance to suit.
Proactive Trial Prep
Strategic defense planning, including mock trials, opposing attorney research, early counsel selection and predictive outcome modeling
Products Liability Strategies
Our legal, medical and investigative experts are equipped to handle any level of claim, ensuring you pay only what is owed and receive unparalleled customer service
Large Loss Governance
Major case teams with claim and technical expertise collaborating to pursue early resolution strategies and develop bench strength
90% of claims resolved without advancing to suit5
73% successful trial verdicts, with 7% coming in at less than the last offer6
80% claims closed at 6 months and stay closed5
60% of claims voluntarily withdrawn or denied for no legal liability5
We work tirelessly to put the brakes on fraudulent claims, reduce attorney and trial involvement and minimize the impact of property damage and bodily injury.
Dedicated specialists use data to predict subrogation potential and help ensure our customers pay only what is owed
Low Velocity Impact
Early identification of low-impact claims aggressively build pre-suit defense to help minimize overall exposure
Vehicle Appraisal Tools
Self-service options for locating repair facilities and virtually inspecting vehicle damage for quicker claim resolution
Heavy Fleet Expertise
Strategic partnerships with designated auto bodily injury experts throughout the U.S., specifically trained to handle the challenges of heavy truck claims
To learn more about how we can help your claim outcomes, contact the CSS representative in your region.
1 2020 Calendar-year Medical Bill Spend
2 Travelers National Accounts 12-month average 2018 to 2020
3 TravCare® 2018-2019
4 Loss Sensitive Years 2013-2018 at 18 months
5 2019 GL claims closed in 2019, excluding incident only
6 2019 GL lawsuits tried to verdict in 2019
© 2023 Constitution State Services LLC is a subsidiary of The Travelers Companies, Inc. Constitution State Services LLC, One Tower Square, Hartford, CT 06183. All rights reserved. Travelers and The Travelers Umbrella are registered trademarks of The Travelers Indemnity Company in the U.S. and other countries. RISKWORLD is a registered trademark of Risk and Insurance Management Society, Inc. All other registered trademarks are the property of their respective owners. BNAIN.000C-D New 4.23
To learn more about how we can help optimize your claim outcomes, contact the CSS representative in your region.
1 2022 Travelers Injury Impact Report
2 “Job Hoppers Leave Extra Work Behind,” May 2022, LinkedIn
3 Travelers Lost Time Claims Data
4 Travelers Webinar, Your Greatest Asset: Smart Risk Management in the Age of Workforce Transformation
5 Based on 2021 Travelers Workers Compensation Data
6 U.S. Bureau of Labor Statistics - https://www.bls.gov/news.release/jolts.t16.htm
7 U.S. National Labor Relations Board
8 2022 Travelers Risk Index: Distracted Driving
Constitution State Services professionals explore what it takes to operationalize the balance between big data and Claim professionals to achieve optimal results.
Predictive analytics can help identify claim trends, equipping Claim professionals with strategies to contain loss costs.
Having trained professionals who understand predictive models, how to interpret the data, and the best way to act on it is the art of claim management.