Crosstie Research Brief: Attorney Involvement Rarely Arrives Without a Warning

What 400,000 workers' compensation claims reveal about the warning signs before an attorney gets involved

This research brief draws on workers' compensation claims data from Crosstie's Platform, examining what 400,000 workers' compensation claims reveal about the claim-handling conditions that precede attorney involvement. It covers the emails, texts, calls, and documents on a claim, including medical records. 

An attorney-involved claim costs an insurer up to four times what a comparable claim without an attorney costs. The brief finds that many of the conditions preceding involvement are operational, appear months in advance, and can be handled through better alerting, automation, and adjuster attention.

Key Insights:

• The first warning sign is on record a median of four months before representation. In two out of three attorney-involved claims the signals are there two months or more beforehand.

• Seven in ten of these claimants never expressed frustration or distress. The warning signs are operational rather than emotional.

• Five claim-handling experiences raise the hazard of attorney involvement. Communication breakdown is by far the most common, present in 61% of attorney-involved claims and raising the hazard by 23%. Denials are rarer and stronger, up to +55%.

• Warning signs compound. A claim carrying three or more of these experiences involves an attorney at nearly twice the rate of a claim with none.

• Roughly one in six attorney-involved claims traces back to a fixable claim-handling breakdown, which on a book of 1,000 lost-time claims carries an annual cost of $2.4M. That share is statistical attribution rather than a measured intervention result.

  
  

View the report: Attorney Involvement Rarely Arrives Without a Warning (PDF)