Our “Star Adjuster” nominees continue to surprise and impress us with the hard work and dedication that we have found claims adjusters are capable of. It seems a lot of adjusters are giving similar advice- “Be proactive”! We just hope our adjusters can find the time to do so!

We love reading about the quality adjusters you work with. Keep the nominations coming by submitting a form on our Y.O.T.A section of WCInsights. Make sure to grab a complimentary copy of our infographic to feature in your office or share with your friends as well, and while you’re there submit your tips for other adjusters!

The next adjuster in our series is Maria Torres. She works as a Senior Claims Examiner for Carl Warren & Company and has been a claims examiner for 20 years. Her nominator noted that she was the “type of examiner every supervisor loves”.  She exhibits a kind of care and compassion that is valued by her clients, and she treats them as she would want to be treated.

WCInsights- Your nominator mentioned your proactive action plans and tendencies to recognize a client’s needs right away. Could you expand on that?

MT- Communication is key to ensuring a great relationship and outcome with all parties.  I work on building a good trustworthy relationship with everyone and by doing so I earn their trust and respect. I am always trying to do my best by anticipating my client’s needs and using this to build my relationships.  I have taken over several high maintenance accounts and built solid relationships with the risk managers and HR personnel. At the same time I build relationships with my injured workers, making sure to answer their questions and return their phone calls. I find being able to speak to my injured workers in their native language of Spanish has also assisted me in obtaining the outcomes that I have. At the end of the day, people simply want their questions answered and this is my priority.

WCInsights- What is the most rewarding part of being an adjuster?

MT- As claims examiner we are faced with many different challenges,  many of my injured workers do not understand the workers compensation system and most feel that the insurance company is out to deny their claim.  It is very rewarding when the injured workers call at the end of each day to thank you for taking the time to listen and for reassuring them that they will be taken care of and benefits will be provided.  I end every call by letting them know that they can always call me or e-mail me at any time with any questions.

WCInsights- What is something that makes your job easier?

MT– I work with an excellent group of people at Carl Warren & Company from the Management team to the clerical support.   I am especially thankful to the CD department for making me feel welcomed. Working with an excellent group of people makes our jobs much easier. I feel very fortunate to be working at Carl Warren & Company.  Carl Warren celebrates its 70^th year in business in 2014; they have achieved this type of longevity by treating their employee-owners well. In my office we have not had any turn over in the examiner position since I started.

WCInsights- What is something you personally do that you think makes the job better for you?

MT- I receive compliments from my supervisors, peers and clients about being very detailed and thorough in my claim summary. I touch all aspects of the claim from injury description to documenting the reserves and the rationale.   I make sure to have a solid plan of action to bring the claim to resolution.

WCInsights- How do you stay on top of claims? If you had more time in your workday, what kinds of things would you be able to do?

MT- As claims examiners we have to learn to balance our workload on a daily basis (mail, faxes, phone calls, daily diaries and e-mails).  I use my time wisely and have developed great organizational skills.  I am proactive on my claims and in doing so, I avoid more work down the road.

WCInsights- Could you share a story of getting an injured worker back to work that had an impact on you?

MT- Several months ago, I had a very young injured worker. A 19 year old who sustained an injury when a tractor trailer rolled on top of him.  He sustained multiple injuries and had several surgeries.  I communicated with the injured worker every two weeks to make sure he was doing o.k.  The NCM and the employer were also in constant communication with him, as a result after only 10 weeks being off work he returned to modified duties and shortly after regular work. By being in constant communication with the injured and reassuring him that he would be taken care we avoided him obtaining legal representation. Working as a team resulted in significant cost savings. 

WCInsights- What’s one tip that you could offer to other adjusters?

MT- Be proactive, respond to the injured workers and clients in a timely fashion. If you can’t answer their question at that moment, let them know you will get back to them by a certain day with an answer.  Ignoring calls and questions is simply going to create additionally work.  We as adjusters deal with many different calls from injured workers to lien claimants, there will be times when you are simply having a bad day; don’t take anything personal.

Thanks Maria!