Starbucks Advocacy earns Teddy Award, Outsourced Claims Advocacy Defined, Benefits to your company.

Starbucks Exceptional Employee Advocacy Program, years in the making earns a Teddy Award. Claims Advocacy defined, how your company and employees benefit from outsourced claims advocacy.

The proof is in the data for Starbucks with the implementation of Employee Advocacy by outsourcing since 2015 as the following has been reported in the latest article by

According to this data by the risk and insurance article, link above, Starbucks has experienced nearly a fifty percent decrease in claims litigation, putting overall litigation rates at less than six percent. Taking a less adversarial approach with placing your trust within your TPA partner may provide a successful approach.

What is the take away here?  First, let’s define claims advocacy. When you hear the words Claims Advocacy, What does that mean to you? If you ask ten people what claims advocacy means, you will receive ten different responses.

Claims Advocacy creates an environment that allows the claimant to feel heard. Addressing the needs and concerns of the injured worker builds and nurtures trust from the very beginning of a claim. This level of customer service prevents the common breakdown in communication between the claimant and carrier, stops litigation prior to the start and ultimately leads to a faster return to work for the clamant when possible with a more cost effective resolution. This all results in drastically reduced administrative costs. An outsourced advocate who understands the full picture from all sides, can connect with the claimant as long as they have had the experience of navigating their own workers’ compensation claim to truly understanding what the claimant is going through. When this connection exists, will provide a very high success rate than any other service.

The human element factor goes a long way with a claimant when true trust is created. Here our outsourced past claimant to new claimant model shines the most, when a communication breakdown  occurs as the claimant knows to ask their adjuster/ case manager to speak with their advocate. This is repeatedly instilled from the beginning of the claim and during each discussion feedback session with the claimant every two/three weeks stopping the carrier from being the catalyst for litigation to begin when calling a claimant non-compliant and defiant leaving no choice but to proceed to litigation by the claimant. The situation is defused when the data and stat reports obtained directly from the claimant with options for resolutions is utilized in real time (emailed within hours of the completed call back to the adjuster/ case manager) as the claimant is happy to share everything with someone who has walked in their shoes and been in the very same place prior.  A past claimant viewed as a true advocate, being outsourced from the carrier/ employer with a voice to speak up on behalf of the claimant to the carrier addressing alternatives for any situation which arises, keeps the claimant compliant within the system by reducing administrative and total cost of risk for each claim.

The key to a successful advocacy model is that there is no one size fits all standard approach. An advocacy service must be custom tailored to your company’s specific needs, as each claim is unique. This makes it difficult for untrained in-house claims managers to implement. Claim managers and adjusters may try to empathize with the claimant, often in spite of their training, claims sustainable trust-based connection is highly unlikely. The claimant’s life has been substantially uprooted, which may make them eager to seek out such guidance for litigation as any trust that develops here is short-lived when being implemented in house.

A qualified advocate will solidify the trust in a new claimant relationship within the first few days of injury or less, though may not be completed in house to be truly successful. The claimant views an in house advocate as just an extension of the case manager or adjuster. Utilizing an outside advocacy service with a previous claimant to new claimant model creates a unique bond that can’t be matched in house or by any other service.

No one can understand what a current claimant is going through, unless they have been in their shoes. The trust factor that develops here is one that no adjuster, advocate, or counsel can emulate, unless they have had direct experience navigating their own workers’ compensation claim.

The Take Away.

As you can see after years in the making, Starbucks outsourced and developed a model that works for their company and TPA.  As reported by risk and insurance a 50% decrease in claim litigation along with an overall claim litigation rate of less than 6%.

These numbers are amazing and show businesses when working in conjunction with their TPA can achieve desired results with claims advocacy.

We must ask ourselves though, why only a 50% decrease in claim litigation when Starbucks made what sounds like a significant investment with numerous variables and services for this program?

To my belief, this means that half of the claimants utilizing this process had an issue or still experienced some sort of communication breakdown within the process leading to possible litigation or such, though none of this information was discussed within this risk and insurance article only providing the positive within this article.

When utilizing a unique claims advocacy past claimant to claimant model, there are no significant changes to our client’s process required to begin with a minimal investment per claim and fees are pro-rated. When a claim closes early the remaining credit will be transferred to the next claim for our clients. Our unique model shines most when the communication breakdown occurs within a claim whereas no other service today can emulate without the experience of navigating their own claim previously, creating a true bridge of trust.

The solution is simple, the future of claims resolution has arrived.

Written by:

Paul Gold

Founder & CEO

PG Resolutions Group

Tel: 1-800-473-4450