Part 2: What Happens When Technology Gives the Adjuster Time Back?
Last week, I introduced you to Sarah. Sarah is completely fictitious, but the workload isn’t.
Sarah represents the adjusters sitting behind desks all over the country, trying to balance claim inventories, deadlines, medical records, phone calls, emails, metrics and an injured person who needs more than a claim number.
At the end of Part 1, we left Sarah with a question: What happens if technology can give her some of that time back?
That’s where artificial intelligence enters the conversation. Let’s get back to my imaginary friend, Sarah.
AI Should Give Me Time, Not More Claims
I’m not afraid of AI. I’m actually pretty excited about it.
If AI can help me summarize a stack of medical records, identify missing information, organize my workload, draft routine correspondence, flag inconsistencies or help me find something buried in a file, that’s valuable. Every minute I don’t spend digging through information is a minute I could potentially spend talking to someone.
But here’s where I think we need to be careful.
AI should not become an excuse to give me twice as many claims.
If technology saves me two hours a day and the response is: “Great! Now you can handle 50 more files.” We’ve missed the point, a point with very real consequences.
The goal shouldn’t be to turn adjusters into claim-processing machines. The goal should be to give those two hours back to the adjuster.
Give me time to make the phone call. Give me time to listen, time to explain, time to recognize that the person on the other end of the phone isn’t just an injured shoulder, a back strain or a knee injury. Give me time to understand the person behind all that. The person hurting. The person I sincerely want to help.
What If AI Actually Made Claims More Human?
That may sound counterintuitive.
We often talk about technology making things less personal, but what if we use it differently?
What if AI handles some of the administrative work that consumes an adjuster’s day, while the adjuster uses that time for the work technology can’t replace?
Technology can’t successfully replace a heartfelt conversation with an injured worker or a call to an employer. AI can’t thoughtfully review what’s happening in the life of the person behind the claim to decipher why treatment isn’t progressing.
AI can process information. It can organize, summarize, and identify patterns. It can help us find the needle in the haystack, but it doesn’t replace the human judgment required to understand why the needle matters.
And that’s an important distinction.
The Diagnosis Isn’t the Whole Story
As discussed in Part 1, I’ve seen claims that looked simple become complicated. I’ve also seen complicated claims resolve beautifully because someone took the time to understand what was really happening.
I’ve seen two people with the same injury have completely different barriers to recovery. One may be worried about money and how to support a family depending on them while another is terrified of getting hurt again and simply needs to understand what happens next.
The diagnosis might be the same, but the person isn’t.
AI may be able to tell me that two injured workers have similar diagnoses. AI may even help me identify patterns in their claims, but it can’t make the decision that one person needs reassurance, another needs a return-to-work conversation, and a third needs someone to slow down and explain what’s happening.
That’s still our job, and honestly, I think that’s the part of the job we should want to protect.
The Risk of Making Efficiency the Finish Line
We love efficiency, and we should. There is tremendous value in eliminating unnecessary work, reducing duplication, finding information faster and making the claims process more efficient. But efficiency is a tool, not a destination.
If we use every technological advancement to simply increase productivity, increase inventory and close more files, we may create a very efficient system that still doesn’t produce better recovery and better outcomes.
We need to ask a different question.
What could an adjuster accomplish if we gave them back the time we’re currently asking them to spend on administrative work?
That question changes everything.
Maybe the adjuster could make the phone call they didn’t have time to make. Maybe they could identify a barrier to an earlier recovery which ultimately saves claim costs. Maybe they could communicate more effectively with the employer to brainstorm unique solutions specific to an individual claim.
Maybe an adjuster could recognize that an injured worker isn’t being difficult, they’re simply scared, frustrated, and shutdown due to mistrust. Mistrust that could be resolved with a sincere, unscripted conversation.
Understanding those whys can change a claim.
Maybe the Future Adjuster Isn’t Less Human
Maybe the future adjuster is actually more human.
Imagine an adjuster who has technology working alongside them. An adjuster who doesn’t spend hours searching for information that could be surfaced in seconds.
Imagine an adjuster who has help with competing priorities. An adjuster who can spend less time documenting every mundane yet important administrative step and more time thinking about the claim.
Imagine an adjuster who has the training to recognize what matters, and the time to act on it. The vision in my mind brings a smile to my face, but there’s one more piece to the perfect puzzle.
Technology or AI alone won’t fix an overloaded claims environment. Training alone is not the answer, nor is just a reduced claim load.
The answer is all three together.
Train adjusters well. Give them reasonable claim loads and use technology to eliminate administrative burdens rather than eliminate the human connection.
So, What Do We Do With the Time?
That’s the million-dollar question, right? If AI gives an adjuster two hours back every day, what should we do with those two hours?
I hope the answer isn’t: “Give the adjuster more claims.”
I hope the answer is more along the lines of: “Give the adjuster the opportunity to do the job they were hired to do.”
Because the ultimate goal of workers’ compensation isn’t just to move claims through a system as efficiently as possible, it’s to help injured people recover and return to healthy, productive lives.
The beauty of it all is that technology can help us get there, but we have to recognize that technology isn’t the recovery model.
People are.
I’m Sarah. I’m still fictitious, but maybe now you recognize others out there like me.
The adjuster who is trying to do the right thing while staring at a screen full of numbers, notifications and deadlines.
Maybe the best thing we can give her isn’t another metric, but more time. Time to think, listen, and care. Time to recover the human side of workers’ compensation.
Remember, every claim tells a story, and every story deserves enough time to be heard.
