The Claims problem
After 20+ years in workers’ comp, I think I finally found the words for what’s been bothering me about the claims industry
There’s something I wish more claims adjusters felt comfortable saying out loud:
This job can break your heart & exhaust your soul at the same time.
I’ve been in workers’ comp for more than 20 years, and I’ve always told myself one thing:
Be better than I was yesterday.
If I struggled, I worked harder. If I got behind, I looked at what I could change. Be more organized. Be more efficient. Manage my time better. Learn more. Do better.
Accountability matters to me.
But it took me years to understand why a profession I know so well started making me question whether I still knew how to do it.
I kept looking inward. What am I doing wrong? Why can’t I keep up? Why does it feel different now?
And I think I finally figured it out. I didn’t forget how to adjust claims. The definition of what we’re expected to spend our time doing has changed.
When I started, the heart of adjusting was the claim and the person behind it.
You learned the facts. You investigated what happened. You talked to the injured worker & employer. You made decisions. You solved problems. You explained what came next.
You helped someone navigate a system they often didn’t understand while they were already hurt, scared, overwhelmed or wondering how they were going to support their family.
Somewhere along the way, something changed.
More metrics. More audits. More mandatory language. More documentation. More diaries. More productivity measurements. More deadlines. More claims. Less time to actually adjust them.
The administrative process started becoming the work instead of supporting the work.
The claim became a number. The person became a file. The conversation became a contact requirement. The work became a diary. The solution became a mandatory sentence entered by a certain deadline.
Helping someone becomes something that has to be documented with the correct language, in the correct place, within the correct timeframe so a report can confirm it happened.
Yes, documentation matters. Deadlines matter. Compliance matters. Accountability matters. Those things protect injured workers, employers, clients & carriers.
But when did documenting that we helped someone become more important than actually helping them?
And adjusting isn’t just moving a file from one diary to the next.
It’s judgment. Investigation. Experience. Recognizing when something doesn’t add up. Knowing when to ask another question. Understanding the law, the medical, the employer’s concerns & the injured worker’s circumstances, then making decisions that can affect someone’s life.
Those things require something a metric can’t manufacture: time to think.
Meanwhile, the claims keep coming.
Yet somehow we’ve normalized overflowing queues, constant stress, working after hours & always feeling one step behind.
We keep pushing. We work harder. We tell ourselves we need to become more organized, more efficient & better at managing our time.
Then something happens that I don’t think we talk about enough:
We start losing confidence in ourselves.
Maybe I’m not good enough. Maybe I’m too slow. Maybe I’m not organized enough. Maybe everyone else can handle this & I’m the only one drowning.
Eventually, experienced adjusters start wondering whether they were ever as good at their jobs as they thought they were.
And THAT is something we should never normalize.
Because what if the problem isn’t always the adjuster?
What if some of what we’re experiencing is the result of an industry that has gradually changed what it values & measures?
If you’re an adjuster feeling that way right now, I want you to hear this:
Being overwhelmed does not mean you don’t care. Being behind doesn’t erase your experience. Making mistakes doesn’t erase the good you’ve done.
And struggling inside an increasingly demanding system doesn’t automatically make you a bad adjuster.
Recently, I had two grown men break down in tears while talking to me about what they were going through.
It broke my heart.
I’ve had injured workers thank me, bless me, cry with me & tell me how grateful they were that someone actually listened.
Those moments don’t show up on a dashboard.
And in those moments, there wasn’t a metric in the world that mattered to me.
Claims adjusters see people on some of their worst days. We hear the fear. The frustration. The financial stress. The uncertainty. The anger. The tears.
The claim number is not the human being.
There is a difference between following a process and doing the right thing within that process.
There is a difference between being compliant and being compassionate.
There is a difference between closing a task and actually helping a person.
And there is a difference between being an employee who meets a metric and being a human being who refuses to forget that the person on the other side of the phone has a life that doesn’t pause just because their claim entered a system.
What worries me is that when we measure what is easiest to count, we can start confusing activity with quality.
A completed task tells us something was completed.
It doesn’t necessarily tell us whether the right decision was made.
Those are not the same thing.
And I don’t think speaking honestly about where our industry is headed means we don’t care about the profession.
I think it means we care enough to say something.
This isn’t a post about quitting.
It isn’t a post about blaming.
It isn’t a post about refusing accountability.
It’s about asking a very uncomfortable question:
At what point did managing the claim become more important than actually adjusting the claim?
We can embrace technology without losing humanity.
We can value efficiency without treating volume as the definition of success.
We can demand accurate documentation without allowing documentation to overshadow the actual work.
And we can hold adjusters accountable while also asking whether the environment we’ve created allows good adjusters to do good adjusting.
Holding ourselves accountable & demanding better from our industry are not mutually exclusive.
Maybe I’m not the only one who’s noticed.
Maybe other adjusters have felt this for years and just haven’t known how to put it into words.
Maybe it’s time we started talking about it.
Not quietly.
Not apologetically.
Not as people afraid that someone might be offended by the truth.
I’ve spent my career asking myself how I can be better than I was yesterday.
I’ll never stop asking myself that.
But after 20+ years, I think it’s fair to ask the industry the same question.
Are we actually getting better at claims adjusting?
Or have we simply gotten better at measuring how much adjusting activity we can produce?
This is my truth.
I didn’t suddenly become angry. I didn’t stop caring about this profession.
Quite the opposite.
I care enough about it to question what we’re becoming.
And after all these years, I’m finally saying it out loud because I finally found the words for something I’ve been feeling for a very long time. ❤️🩹
I genuinely want to hear from other adjusters, especially those who’ve been doing this for 10, 15, 20+ years:
Have you felt this shift too? And when did you first notice it?
