Historically, workers' compensation claim professionals and their performance primarily have been measured by audits that determine their compliance with company policies, procedures and state regulations. Audit emphasis is placed on 24-hour contact, file documentation, action planning, reserving and completion of company and regulatory reports and forms.

While all of these elements are important in the claim management process, measuring performance solely on this basis tends to drive behavior toward passing audits. Unfortunately, a successful audit does not mean an individual or claim operation is effective at reducing claim costs and improving the employer's bottom line. The goal should be to create a performance measuring system and employee incentive program for claim professionals that focuses on effectiveness and results.

Establishing Benchmarks