Beyond the Claim
Beyond the Claim

Episode 12 · 2 months ago

TPA vs Corporate: How Do They Stack Up w/ Jaclyn Chapman


A career can take you to many new and unexpected places.

With a field as diverse as claims management, moving from one area to another can be daunting.

But if you’re thinking of exploring other facets of the industry, it helps to know what other veteran adjusters have learned along their storied — though not necessarily linear — career paths.

And today’s guest, Jaclyn Chapman, Senior Global Claims Manager at Primo Water Corporation and former med student, knows a little something about career transitions. She joined the show to share the insights she’s picked up along the way.

Join us as we discuss:

  • TPA vs corporate claims
  • How the pandemic has affected workers’ comp
  • Why the great resignation is forcing businesses to innovate their claim management    

Need more claims strategy in your life? Check us out on Apple Podcasts, Spotify, or on our website.

Listening on a desktop & can’t see the links? Just search for Beyond the Claim on your favorite podcast player.

What they're demanding is, you know, greater access to tech, greater advances in education. They want, you know, a more Savva adjuster. They want more resources available to them. You're listening to beyond the claim, the show for forward thinking risk and claims professionals curious about the latest industry trends, winning strategies and stories from influential leaders. Let's dive in. Hello everyone, welcome to this episode of beyond the claim. I'm your host, smart Cunningham, chief sales and marketing officer with broad spire. Today I have the pleasure of joining me Jackie Chapman. Jackie is senior global claims manager with premo water corporation out of Tampa, Florida. Jackie, welcome, thank you. Thank you for having me. Absolutely excited to have you today. So, before I dive into the world of your experience and claims and we get into our conversation, I have to start at Tampa. So I'm and I'm in south Florida myself. I'm a native Floridian. I used to be one of the rare few, but with all the transients that came down from New York at one point of time and the pad kids now I'm no longer that special. So are you? Are you native as well? Originally from South Florida. Moved Up to Atlanta when I was young and did a lot of my kind of schooling in Atlanta, but have been fortunate enough to now find myself back in Tampa. So I'm loving it, absolutely happy here. Wonderful. I totally Red Yellow Florida. Travel a lot and I have no desire love other states for those of either are in other states, but I will always come back to Florida. There so many things to offer and see and the lifestyle is just it's just, it's different in a very positive way. So very very much. So, yes, yes, great, all right. So I Jack, you have a interesting background and I love to hear for the eyes, to hear about your background in detail. Whenever that I want to start off with was, I think, give a premed that ground. We come across some interesting pathways. This is definitely a space where the journeys are different and not often linear, but premed is one that I have not come across yet. So please, can you share your story, share your joining your journey with this? Sure, absolutely so. I find that most folks don't end up in the claims business by purpose. That kind of fall backward into it a little bit, so to speak. But my journey originally was on the pathway to become a physician. I wanted to deliver babies for a living and that's I was very focused and that's the direction that I was headed. And Life, as it does, sometimes intervened and my my journey kind of pivoted a little bit and ended up with me at a TPA while I was working through college and really enjoyed that space. Saw An opportunity to actually jump full force into claims and really just decided that that was a space that I wanted to continue in and made a full career out of it. And so I think I've been doing this now for about twenty five years, almost twenty five years. Spent a considerable amount of time on the TPA side of the house, but then also moved over to the corporate side, where I am now and have been for since two thousand and sixteen ish. So have worked for a couple of different companies on the on the corporate side, but it definitely having that the strength of the TPA background has been absolutely advantageous for me in this space. It has allowed me the opportunity to really see both sides of the fence, both sides of the coin, and it's just been a it's been a fantastic journey. The premed background is it. While you wouldn't think that it would come in to play much, I do find that it does assist me when I start to peel back the layers of a claim and look at the details. End Up, you know, being able to really understand medical records, which is is certainly helpful. So, although I wouldn't say that it I use it for its intended purpose, I definitely get...

...some use out of my background, for sure. Wit Education. I can definitely see how those of our listeners that, you know, aren't deep in the either risk or benefits side and then you're just learning or getting your testing the waters. It's heavily, heavily driven by a clinical influenced perspective. So yeah, I can definitely see how that background could be useful. So yeah, so you talked about having spent time and the suppliers space, with the TPA environment, as well as on the the employer side, with corporations. What would you say if I was to hold you too? Maybe it's some of the top three differences or you know that doesn't happen three. I don't necessarily. But what do you say? What did you see dramatically change? Was it a big pivot for you? Was it shifting your just your focus in your perspective? When you say the main differences are so I think the largest change that I've seen is really been on the TPA side of the house. I've found that TPA's have really had to become more innovative. In innovative they certainly have had to add challenge of staying abreast of the times and keeping up with things like technology, for example. You know, I certainly was not involved in the the heyday of the claims industry where we were, you know, using double sided paper to record notes and handwriting file notes in a in a file, but I definitely remember facts machines and when I think back and I look back over just the years on the on the TPA side, I feel like that has been an area that is has been continuously evolving really not out not only out of necessity, but also because it's what the you know, the corporations are requiring, and what they're demanding is, you know, greater access to tech, greater advances in education and they want, you know, a more Sava adjuster. They want more resources available to them. One area in particular where, you know, we've stressed, in an area that I think I'm, you know, really proud of in my position of my three years at premo, has really been through our consolidation of our claims operations. That is, you know, an area that, when I came on board, was a focus that we needed to really pay some quick attention to. And, you know, going through an RFP and interviewing a number of different TPAS and really examining what their opportunities were and what their advances were, I got to see a lot of really good things and a lot of areas that, you know, probably could continue to evolve and continue to develop with certain organizations and so and that why you're saying going from a multi vender programs who maybe a singular or do you mean about reevaluating the the premo management team or supply team to say, okay, you know, based on technology, you're based on process, we can either realign or get more efficient. How did you lose the approach? Yeah, so, I mean it's it really was too fold we did have our claims operations and claims management spread out over a variety of of TPA's and when we went through the process of conducting an RFP, obviously we're interviewing and meeting with a number of the different providers. We met with the incumbents, but it was a a star contrast to see how some organizations really have continued to stay ahead of the times and continued to innovate and poor resources into the development of every service that's offered it a tpa, whereby some, you know, other tpas maybe hadn't grown necessarily as much, and it's an ad advantage to corporations and, you know, large ensureds that you know there there is such a variety out there, variety of service providers that can help with really every need from from start to finish. And ultimately we made the decision to go with a singular TPA and we've consolidated our operations on a global basis. So we've partnered specifically with our current TPA,...

...not only through the domestic us but also into Canada and then in twenty additional countries across the globe. So it was it was quite an undertaking, but it was definitely something that was was necessary and very pleased by the by the results that we've continued to develop through the partnership. And when you look back on that, leave the initial exercise, I'm sure there are plenty of learning through. Anything that stands out that you would have done differently or different approach that you would take, you know, down the road, if you had to? Well, you know, I don't know that they're necessarily would have been a different approach. I think we approached the you know, the process pretty methodically, right. So you do a lot of kind of discovery and data gathering and do your due diligence to understand where all of the moving pieces of the puzzle are and then you work towards bringing them together. So having a strategic vision on ultimately, you know, how we wanted our claims program to look really was the focus. I don't know that we would have necessarily done anything differently. Obviously we, you know, want to continue to partner with an organization that really becomes an extension of our business and that really is is a critical factor for us as who, if we're going to invest all of these resources, all of this this time and money and effort into this partnership on a global basis. We wanted to be assured that we were with an organization that really could tackle all of our global claims management needs. And so, while it was a laborious process, certainly, to go through an OURFP, any RFP is you know, ultimately I think the the process and the ultimate outcome was was really effective for us. Yeah, that's great. That's great, that makes a lot of sense. So, Jackie, when you we fast forward a little bit and we look at those of you listening, we're recording in December of two thousand and twenty one. So we are, I think, close to two years now into this pandemic. I have no idea what warter we're in anymore because of all the having and flowing at this point, but you know that. Talk to all our guests. We kind of touch on the pandemic from time to time and it's interesting how it's touched each organization slightly differently. I think what's consistent is that an initial rebound or reaction period in the early q q one on the pandemic. But as you look back over the past severe years, what's stood out to you most dramatically? Specific the premo or does in general? Have you had to change how you approach claims? Have your claims dramatically changed and the type of claims? That what was stood us you the most? A yeah, I mean so certainly, I don't think our organization was immune to the challenges so that the pandemic has brought forth, you know, certainly throughout the US and into Canada and to our our European operations. We we we had to pivot and we had to be pretty aggressive on the front end and I'm I'm very proud to say that as a company overall, we really did take concerted and aggressive efforts to stay ahead of the downturn and to really anticipate, you know, what was happening from an economics standpoint with respect to the pandemic. I mean, you know, the the senior leadership of our organization certainly had to make some tough calls and make some tough decisions, but ultimately I think as a business we have been fared better for it. From claims perspective, you know, part of kind of that buckling down effect of the pandemic meant we have seen arise and workers comp claims. Certainly, you know, we also have seen an increase in our auto frequency. You know, it doesn't necessarily mean our severity has gone up, but certainly from a from a frequency standpoint, we have seen an increase in the claims of volume and that is it's I think there's a number of explanations for that. You know, one explanation, I think, is trying to do more with less, right. So we're trying to continue to maintain profitability, which means you have to you have... make component, you have to compensate in other areas and you know we have service providers that are, you know, doing more with less and unfortunately, I think in many environments you see that sometimes that can increase workers complaim. Sometimes, you know you're you're stretched a little thin and you're you're trying to make sure all of your customers are are receiving their their product and are satisfied as much as possible. And you know, accidents happen. You know. I think as an organization, the pandemic has allowed us to really focus in on, you know, our safety, our safety metrics and how do we keep these accents from happening once we get on the back side of the pandemic. Right. So once we're once we're, you know, no longer having to kind of manage through the economic downturn, where do we come out on the other side? So it's given us an opportunity really to kind of focus in on not only safety measures but from a claims perspective, how do we control these claims? How do we control the the incidents that have come out of the Pan Damoch to really generate some cost savings to keep them from going going haywire, because the longer claim stays open, the more expensive it becomes, and so, you know, that is a challenge that we're continuing to work through and you know, the staffing challenge also is another thing that is has really kind of impacted our organization and you know, I think a lot of companies are kind of scratching their heads and trying to address the same same issues. You know, how do we attract better talent, how do we retain the talent that we have and continue to develop the folks who are currently with the organization so that we have that lasting kind of corporate knowledge and footprint so that our organization does maintain stability. And so, you know, I think the the hiring challenge has has also kind of blood over into kind of the workers comp space for us, in so much, as you know, we have associates who sometimes will come in and, you know, on day one, day two, day three, unfortunately, you know, they have an accident. And then so then we have an associate who goes out and is, you know, out on workers comp and has only been with the group for, you know, a couple of days, a couple of weeks, etc. And so then it's kind of a level setting, right. So when you have an associate who comes in and is injured that quickly, they really haven't had an opportunity to getting grained in the culture and getting grained in the organization and and really understand who we are as a company and as an employer and why it is so important for them to come back to work and why we value them as an associate and as an integral part of the business. So that is something that we're continuing to kind of challenge through and, you know, it's it requires input from all departments within the organization. It requires, you know, the the risk management team, it requires the HR team, it requires the benefits team and, you know, all the way up and permeates kind of every aspect of the business. It's kind of all hands on deck, so to speak, on trying to get through the pandemic challenge. Yeah, and that's you taking an interesting take on the great resignation or the great quip and and these hot to environment that we're in. But from the standpoint you definitely, I think everyone feels it from a do we have enough people in the business to provide the services that we've all committed to in our respective business but I think your your your additional component saying that, from a claim standpoint, you're actually seeing that also contributes to more claims because you maybe have less expertise or you have individuals trying to do more than they normally would be in the exceeding their bandwidth, and maybe that leads to, you know, accidents or or other issues that wouldn't have happened otherwise. They are being cont directly linked to the fact that we don't have enough people necessarily in this is across all companies and businesses potentially that have done that the job at efficient level. That would have avoided this incidents, this claim...

...from being necessary to begin with. It that's a that's an interesting take. You know, I think that's something as a industry that we need to look into. Gott to believe that there's some data to show, you know, the correlation that and I'm making an assumption that there is, but I think, given the space that we're in, that yeah, you can see that. That makes sense. That's that's into it a maybe we should will do some analysis to connect those that. That makes complete sense and you can actually see it. You know, I mean it. It's definitely not singular to to my company, but you can see it when you start looking at the actual data, right and you start running you start pulling loss runs and you start running through the actuary or reports and you're looking at, you know, what these numbers are actually coming out and it's a start contrast. It's a start difference pre pandemic versus post pandemic. And on the other side of that, the extension of that is really on the claim side, right. So we talked about this hiring challenge in the great resignation not being just singular to one business or one organization, but what we're seeing, at least retrospect to my claims program is just this kind of mass exodus and shifting of adjusters and adjuster resources, whether at carriers or TPA's. I have one, you know, carrier partnership in particular, where I had a change of three different people within this span of six weeks. So now not only am I dealing with, you know, a challenge on my end as the ensured, you know, from a frequency standpoint, but now I'm I'm dealing with folks on, you know, the insurance carry your side and and or tpa side that, you know, no longer have the knowledge of my company, no longer have the history in the background and really the perspective of how we approach claims and what our philosophy is. And so it's it really is to say that it's a challenge and every respect would be putting it, putting it mildly, but that is something, I think, that that employers overall are going to have to continue to work through as we get into two thousand and twenty two and beyond. Is How do we address these the staffing issues and these these reasons why there's this kind of mass exodus and his great resignation going on. Absolutely, you know, it's one of those cases where misery doesn't necessarily the benefit of misery and company. You can do with that. Right now, it's exactly know what's whatever degree there is an employer leverage that you know. I think that that's probably not the appropriate way to take it, but the degree of influence that the employer has shown in in the staffing arrangements, it is shifted dramatically. You know, we have, I'm sure you've felt as well. I've read articles that have shown the same, where positions of all levels, you know, you have no shows at interviews and you have pretty highly compensated positions where not just the you hire and then you dealing with ongoing attrition. In some cases they're not even entering the door or it's there, their books are leaving during training. Of you read for multiple companies. So makes it difficult to your point to you in bed and you into the culture, to build up that level of understanding of the job of and build out a a career path. And it happened that a much earlier stage in a probably would otherwise than look, it's impacting us in our personal lives that I can't be alone, where you go out to a restaurant and you really have to really have to exercise your patients because either the food is different or the service is different, while they're going through the same things where they're having the turnover. And if you think about it, that person is maybe new to that space and maybe makes a mistake that they wouldn't have with someone that's more of an expert in that trade. And there you have a claim potentially because now they're injured. There they had a burn or whatever it might be. Right. So all those things, to your point earlier, are that lack of depth of expertise can definitely have impact on the claim and you know it possibly the severity as well. Agreed. Yeah, absolutely so. When you look..., you know, the future state, let's say, where we're all able to successfully come out of this current phase soon, and you know, we look at where we want things to be down the road. You touched on when you were doing your due diligence and reviews of your vendor suppliers and seeing in some cases that there were the real focus on technology. When you look future state, is the technology or what components of the claim process you really want to see evolve? And maybe is there anyone in particular that you have an idea of thought or vision of where it could be, you know, five, potentially than ten years down there. Certainly, technology is critical part of any successful and robust claims management program so you know that will continue to develop as as the industry develops and as companies develop and as needs develop. What is going to be critical, I think, for us, and we're getting into it, you know, pretty aggressively now, is analytics and predictive analytics. And what does that mean for the future state of our claims in a year, in two year and five years and ten years from now? You know, it's it's nobody seems to have a magic crystal ball, but as far as you know, predict predictive analytics are concerned, it's about as close as you're going to get to being able to kind of predict the future and predict what's likely to happen. So certainly we'll like to continue to see those fine tuned and concerns and see those, you know, continue to develop, you know, from a from a personnel standpoint. You know really I think that is something that is we're going to need to focus in on, both on the TPA side of the House and and also probably the you know, the corporate ensured side of the House is really personnel management and developing the resources that you currently have and attracting resources that are going to continue to stay around and continue to grow with your organization. You know, one thing that it doesn't keep me up at night, but it's definitely something that I have some concerns about is, you know, given the turnover that I have had with adjusters, whether it's at it at the TP are, at the carrier side, what does that mean for the new resources kind of coming on board right? So, you know, I as I kind of started out our chat, there are not a lot of folks who end up, at least from my perspective, in the claims industry by choice, you know, I mean they're obviously there are degrees and risk management and folks go on and and there's a lot of really solid risk management programs, but you know, in my experience I don't routinely find that those folks coming out of risk management programs say, wow, I really want to go be an adjuster for a living, I want to manage claims for a living. It's it's pretty a typical. So, you know, is as we're continuing to manage through these things, what is that going to do to our talent pool in five years from now and ten years from now, you know, are we going to have the resources available to us as folks continue to retire and decide that, you know, having upward mobility or having even lateral mobility is is more important to them than staying through, you know, staying with an organization and continuing to grow and develop with that company. I mean, I'm I worry and I have concerns of about what that means long, you know, long term, for for our claims management resources, because no matter what you try and do with technology the business as a whole, there is a human component associated with it, and so you do, you do need to have those human resources available to you that are, you know, effective, or your claimsmangre at program overall is going to suffer and costs are going to going to go up. I couldn't be with you more. I mean, we've made significant investment in our, you know, machine learning platform and our analytics. But to your point, we've also been talking for several years now about, you know, the the silver tsunami, the great retirement that's coming up, and I think that, as much as the Anavius is a challenge to all of...

...our peers from a supplier perspective. As much as we're focusing on our approach to, you know, to adjusters and staffing in general for our company, I know we're also equally focusing on that early career path and I think one of the challenges that we have to address as an industry, and this is both on the employer side and and on the vender side, is we need to be willing to bring in and groom and coach young talent consistently and we need our customers to also be supportive of that. And so I know that there is a hesidency to, you know, to have a team of, you know, early career path adjusters and maybe there's another way to approach it, maybe there's a balance approach, maybe there's a gradual increase of something to that effect. But we can only tap the same people for so long before we're going to run out of people to tap on. And you know, it said the service to both our employer clients as well as to, you know, to those individuals that are trying to grow in a very respectable career. I'm a big proponent of education and you know, it's it can take you boundless places, and so I'm very encouraging and very supportive of of my team. In fact, I had a call this morning with one of the folks on my on my team internally, who mentioned that she wanted to go ahead and lock in her first aic course, and so certainly very excited about that and super supportive and encouraging of that. You know, any resources within my group that want to continue to expand their education and develop, you know, and I see the need. I see the the opportunity, I think, on the TPA side and the carrier side of the House to continue to, you know, market to folks coming out of college and bringing in those younger resources, because you know, at the end of the day, they are going to be the ones who are going to take over the rains, you know, from the you know from the folks who are retiring, and we need folks to get excited about claims. We need folks to get excited about, you know, the risk management industry overall, and you know, I there's certainly opportunity for growth and development there. I think, yeah, going to do with you more. Thank you so much. We're out of time for today is episode, but this has been really insightful. So, Jack, and know that you are a leaver and speaking engagements and really getting continue to get the word out about our industry. I'm sure we'll have some folks that want to reach out to you and maybe pull you into their panel or as a individual speaker. What's the best way to get in contact with you? Sure, and thank you very much for having me today. The best way to reach me is through Linkedin. That's the easiest way and look forward to speaking and talking to any of your listeners and viewers and, you know, just continuing the conversation and continuing the dialog, because I certainly love what I do for a living and excited to share that knowledge and and bring folks to the table who maybe don't have the same excitement just yet. Thanks. Thank you so much. Always excited to speak to leaders like yourself in industry and know that we're in great hands as we continue down this journey. So thank you so much. To thank you you've been listening to beyond the claim, a podcast for risk and claims leaders. To ensure you never miss an episode, please subscribe to the show in your favorite podcast player, if you use apple podcast. We'd love for you to give us a quick rating for the show. Just tap the number of stars that you think the podcast deserves. Until next time, stay curious and keep innovating.

In-Stream Audio Search


Search across all episodes within this podcast

Episodes (15)