Compliance Corner
Under Colorado law, insurers must hit claimants up for some survey information. What does the Rocky Mountain State look for from such surveys? Thanks to Simply Research, we take a gander.
Who gets Surveyed?
Within 30 days following closure of each claim that was reported to the Division, the insurer shall survey the claimant. If the claimant is deceased the survey shall be presented to the claimant’s dependents, if there are such dependents. If two or more claims have been merged or consolidated, one survey may be presented.
Sending the Survey
If the claimant has previously authorized the insurer to communicate through electronic transmission, the survey may be sent to the claimant electronically. Otherwise, the survey shall be mailed to the claimant. If mailed, along with the survey, the insurer shall provide a return postage prepaid envelope for the claimant to use when returning the survey. The survey shall include the name of the insurer.
The survey shall also have a space for the claimant to sign if communicated by mail. The survey shall include the following language: “This survey relates to your recent workers’ compensation claim. We would like to find out how satisfied you are with the way your claim was handled.”
Survey Questions, Instructions
The survey shall include instructions as to how to return the completed survey to the insurer, and the sentence “Insurers and employers are prohibited by law from taking any disciplinary action or otherwise retaliating against those who respond to this survey.”
In addition, the survey shall set forth only the following questions:
1. On a scale from 1 to 5, with 1 being the least satisfied and 5 being the most satisfied, please describe your satisfaction with the level of courtesy shown to you in relation to your workers’ compensation claim.
1 2 3 4 5
2. On a scale from 1 to 5, with 1 being the least satisfied and 5 being the most satisfied, please describe your satisfaction with how promptly you received medical care.
1 2 3 4 5
3. On a scale from 1 to 5, with 1 being the least satisfied and 5 being the most satisfied, please describe your satisfaction with how promptly your claim was handled.
1 2 3 4 5
4. On a scale from 1 to 5, with 1 being the least satisfied and 5 being the most satisfied, please describe your satisfaction with how quickly any disputes in your claim were resolved. If you did not have any disputes, please mark NA.
1 2 3 4 5
5. On a scale from 1 to 5, with 1 being the least satisfied and 5 being the most satisfied, please describe your overall satisfaction with the way your claim was handled.
1 2 3 4 5
6. The name of the adjuster handling your claim, if known.
Reporting Results
On or before the last day of January in each year, the insurer shall report the survey results to the Division. The report shall include the total number of surveys presented to claimants during the preceding calendar year but shall be based on all survey results actually received by the insurer during that time.
For the questions set out in (1), (2), (3). and (5) above, the insurer shall report the number of responses to the question and the average score based on those responses. For question (4), the insurer shall report the number of responses to the question, the number of responses that indicated NA, and the average of those responses that provided a numerical response.
There shall be only one report per insurer per year. The insurer shall maintain the actual survey responses for a minimum of six months after providing the results to the Division and shall provide the survey results to the Division upon request.
