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Disability Claims Analyst: Case Study

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Throughout my career, I have always been more interested in the why than the how. Why do we have to do it this way? Why do I have to look in three places to find one answer? As a Disability Claims Analyst, I face these questions often.
I walked away from UMass, Amherst in the spring of 2004 with a Bachelor of Arts degree in Communication and moved to Boston, MA to begin working as a Disability Claim Representative with a small disability management company. I learned quickly, soaking up insurance lingo: elimination periods, partial disability versus total disability, material and substantial duties, evidence of insurability; in between writing detailed letters, phoning claimants, calculating benefits and forming an appreciation for well-led …show more content…
Not ready to move away from the city, I chose neither and ended up securing a job with a much larger insurance company, Sun Life Financial. Right from the start, the company put me on a project to identify settlement worthy claims by skimming through other examiner’s files. I knew early on the process was sure to rankle some of the established employees by basically rummaging through their stuff. The task was at odds with employees knowing their files and the company’s core value of accountability. After a couple of weeks of presenting files to management, I introduced the idea of educating the department on proper claims for settlement instead of continuing to ostracize myself from my new co-workers. In this way, examiners could identify files and I could work on referrals. Management was receptive to the idea and due in part to an educated claim staff, settlement referrals steadily increased thereafter to the level of $10 million in annual savings. After eight years and several position changes, I left one large insurance carrier for more growth potential with Prudential

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