HR Know-How: Employee Claims Issues Solved

/, HR Best Practices/HR Know-How: Employee Claims Issues Solved
Helping EEs with Claims

Navigating the health care claim process can be challenging for employees, and delayed claim payments and denied claims make it even harder for employees to manage their health care. Employees often lack the knowledge or experience to handle these hurdles in the claims process; for instance, many employees don’t think to follow up when their claim is unexpectedly denied, yet erroneous claims denials happen more often than they may think.

Your HR department can be a valuable resource for employees in this situation, but how much of a role should your HR department play in helping employees sort through problem claims?



Time Sink

Some HR pros may feel that helping employees sort through claims is an unnecessary drain on their time. Employees may start turning to HR as their first point of contact, which may increase this issue.

Working with an insurance broker like Austin means you have a designated representative to help you and your employees solve claims issues. The knowledge and extra time a broker can dedicate to these issues will alleviate the strain on HR and also help ease the stress of employees dealing with insurers.

Liability Risk

You may have a fear of your business’s liability when helping employees with their claims. This could be in relation to the American Disabilities Act (ADA) or privacy laws like HIPAA. While risk is minimal, it’s still a good idea to consult legal counsel or work with a knowledgeable partner in these areas.


Save Productivity

Employees may use company time to handle insurance-related problems, cutting into their productivity. If HR can offer assistance to solve their problem, less company time may be wasted. Even less time can be wasted if you have a broker who handles claim issues directly, helping save both the employee’s and HR’s productivity.

Monitor Insurer Performance

Having a better picture of how your insurer is treating your employees can be a benefit when it comes to renewal changes. Carrier performance should be a consideration based on your business’s investment in providing benefits and your employee’s health and well-being. A broker can monitor carrier performance at the employee level by understanding the frustrations of the employee and helping to solve complex issues.

Increase Employee Satisfaction

When employees struggle with solving claims issues, it can lower their overall satisfaction with their benefits package and even your company altogether. By helping solve their claim issues you can avoid unnecessary frustration and improve their outlook on your business.


Many claims issues are simple to solve, download “Top 5 Claims Issues Solved” to help your employees more efficiently. Make sure that if you work with a broker, they are offering you top-notch service at the employee level by helping with problematic claims.

Not sure if you’re getting all you need from your broker relationship? Schedule a consultation or email to request our free Broker Scorecard.

profile photo

Amanda Coe
Marketing Specialist

2022-02-22T19:16:58-05:00 Employee Benefits, HR Best Practices|