Road to recovery: Workers’ Comp and Managed Care

Record date: 7/14/26
Air date: 9/9/26

What if helping injured employees recover and return to work faster can help reduce workers' compensation costs as well?

In the first episode of our new Claims in action: Driving better business outcomes podcast series, Catherine Marciniak, SVP and Head of Property & Casualty Claims at Zurich U.S., sits down with Neil DeBlock, VP and Head of Workers’ Compensation Claims at Zurich U.S., to explore how workers' compensation and managed care work together to improve outcomes for both employers and injured workers. The conversation covers today's biggest cost drivers, including medical inflation, increasing claim severity and evolving treatment patterns, as well as the critical role of coordinated care and pharmacy oversight. Catherine and Neil also discuss the importance of return-to-work programs and how effective claims management can help control costs while supporting employee recovery.

Tune in for practical insights on how proactive claims strategies can drive better business outcomes and stronger workforce resilience.

Guests:

Neil DeBlock
VP, Head of Workers’ Compensation Claims
Zurich U.S.
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Neil DeBlock is Vice President and Head of Workers’ Compensation Claims at Zurich U.S., where he leads strategy, operations and performance across a large national workers’ compensation claims organization. With deep expertise in complex claims management, managed care, and alternative risk solutions, he is focused on improving customer outcomes through operational excellence, data-driven decision making and innovative claims strategies. Neil is an active industry leader, serving on the boards of the Workers Compensation Research Institute (WCRI) and the California Workers’ Compensation Institute (CWCI) and is a frequent speaker at industry conferences, including the NCCI Annual Insights Symposium.

Host:

Catherine Marciniak
SVP, Head of Property & Casualty Claims
Zurich U.S.
Connect on LinkedIn

Catherine Marciniak is the Senior Vice President, Head of Property & Casualty Claims for Zurich U.S., leading teams responsible for delivering exceptional claims outcomes while driving operational excellence across the organization. Based in Schaumburg, Illinois, she is recognized for her collaborative leadership style, commitment to developing talent and ability to navigate complex business and claims challenges with clarity and purpose. She is known for building high-performing teams, fostering strong cross-functional partnerships and bringing both resilience and authenticity to her leadership

(PLEASE NOTE: This is an edited podcast transcript, capturing speakers with natural speech patterns that may include incomplete sentences and/or asides, grammatical errors, verbal shorthand and some statements that may be less clear in print.)

EPISODE TRANSCRIPT:

CATHERINE MARCINIAK:

For employers, the difference between simply managing a claim and actively coordinating the right care can directly affect lost costs, employee recovery and return to work outcomes.

Welcome to Future of Risk, presented by Zurich U.S. We explore the changing risk and resilience landscape and share insights on challenges facing businesses today.

This episode begins our Claims in Action miniseries, focusing on how claims drive better business outcomes. Today, we’re looking at how claims help customers reduce loss costs through the work we do every day across Workers’ Compensation and managed care. I'm Catherine Marciniak, Zurich U.S. Head of Property and Casualty Claims, and today I am thrilled to be joined by Neil DeBlock, our Vice President and Head of Workers' Comp at Zurich Claims U.S. Neil and I are going to talk about what customers should be watching in the workers' comp space, how managed care supports better outcomes and how coordinated claims handling can help reduce the overall cost of a claim. Neil, thank you for joining us and welcome.

NEIL DEBLOCK:

Well, thanks for having me.

The biggest workers' compensation cost drivers to watch

MARCINIAK:

I know you are a very experienced veteran when it comes to workers' comp, so I'm going to give you kind of an easy one to start off with. Curious what your thoughts are around what are the biggest work comp cost drivers our customers should be watching out for today?

DEBLOCK:

First of all, thank you for saying veteran and not saying, you know, <laugh>, um, an older one. Right. So that sounds good. I think the biggest things today, when look at cost drivers, are a few. I'm going to mention a few, focus on one. Medical inflation. We all talk about that one.

MARCINIAK:

Right?

DEBLOCK:

You also have increasing claims severity, which we talk about as well. You have wage inflation; you have litigation that's ongoing in certain jurisdictions where it's growing and growing. And then you have workforce demographics, meaning the aging workforce. But I really want to focus on medical inflation today. When I say inflation for medical, I'm not talking about the increased cost of medical treatment. I'm really talking about the utilization of that. We're seeing more and more treatment for injuries we've seen in the past. That's what you want to keep your eye on more than anything else. When you're talking about these types of things, looking for treatment patterns and things like that to make sure they're going in the right direction. As a claim prolongs itself, it becomes more duplicative and you're seeing more and more, I would say, run-on treatment than you need to see. You can look to certain areas like the NCCI (National Council on Compensation Insurance) or CWCI (California Workers' Compensation Institute) as well, and they'll show you the same exact type of thing in some of their studies.

MARCINIAK:

And I think that was one thing that I know you and I had the pleasure of attending the NCCI conference earlier this year. I think it was in May, and that's exactly what they were talking about. And they referred to it as the modality, right? And it wasn't necessarily about the severity of the treatment that our customers were receiving, our employees were receiving. It was more about the frequency of said treatments. So, is that something that you're seeing quite often in our claims as they're coming across?

DEBLOCK:

Yeah, we're seeing it. It's become more of a norm than a rarity, unfortunately, in claim service. And that's why we have such things as, you know, our UR (utilization review) department and our managed care department, who do review bills and stuff like that in order to make sure that we're not going down that path.

MARCINIAK:

So, I think that's one of the benefits of having a strong workers' comp and managed care network is our adjusters and our employees are looking and monitoring for those trends, right? Trying to help our customers understand how certain treatment patterns can play out and how those can have an impact on their loss costs.

DEBLOCK:

That's correct.

Supporting return to work through effective managed care

MARCINIAK:

So, I'll pivot a little bit here into the managed care space and just kind of pick your brain on, you know, how do you see managed care helping our customers reduce loss costs while also helping to support the injured worker?

DEBLOCK:

From the employer standpoint, they're getting the ability to use our networks that we do contracts with, whether it be physical therapy, prescription and things like that. We do a bill review, the ability to look at bills and bring those down to whether it be usual and customary, your fee schedules. We have pharmacy oversight and, as you're well aware, we have pharmacy cards that go out to our injured workers that allow them to get that first fill right away, without having put money out of pocket. And I already mentioned the UR (utilization review) earlier, but that's another one where you're making sure you're getting the right evidence-based treatment. Now, as far as our employee is concerned, that allows us to just get them to the right doctors in the right places. We vetted these people; we know that they have the right credentials in place and that they're good doctors to gain the best possible treatment from us as the insurance carrier to make sure that they're getting themselves back to their pre-injury status as best we can and back to work.

MARCINIAK:

And back to work. I think that's a really important part and something that we're all striving to do for the injured worker. You touched on medical bill review. That's a nice little segue into our episode two, so everyone stay tuned for that, where we will dive a little bit deeper into medical bill review. But Neil, you're absolutely right. When it comes to managed care, we're trying to get better outcomes and better pricing for our customers while ensuring that the injured worker has the appropriate level of care and they're getting the best care. So, seeing as how you are a veteran worker's comp expert, you've seen great claims outcomes, you've seen probably less-than-great claims outcomes. Curious, in those two experiences that you might have had, what did effective coordination look like for a customer in one of those good claim outcome situations?

DEBLOCK:

Well, the most effective is that it's seamless. They don't even see it happen, as the customer. As far as they know, it's all in the background. There's no need for them to be involved at all in the process whatsoever. That is what makes it key. Now, how do we get there? It's the prep work we do as an organization and make sure that we have these things in place for our customer. It's the coordination, it's the follow-up. It's all this execution that we do in the background and they see no part of it whatsoever. That's the key. That teamwork, where you have claims, managed care, medical resources, vendors, risk engineering, all working together for that common claim strategy and that good outcome for the customer. I always say customer; I like to focus on the claimant. We are here to help the claimant get back to where they were pre-injury. That's our ultimate goal. We're here to help people.

MARCINIAK:

I love how you said it has to feel seamless.

DEBLOCK:

I also enjoy seeing the communication. Great communication goes back into that seamless outcome for the customer.

Why prescription oversight matters in workers' compensation claims

MARCINIAK:

Yeah. When they're in the know on what's going on, things feel seamless, right? Because expectations are being set and then delivered upon. So I'm going to pivot a little bit and ask you some of your thoughts and opinions on pharmacy oversight. So where, where does pharmacy oversight and treatment access? Where does that fit into the loss cost story? How important are those things? What's your view on that?

DEBLOCK:

So pharmacy, you can go back many years ago to the whole opioid crisis because that was a great example of us working with our PBM pharmacy,

MARCINIAK:

Benefits.

DEBLOCK:

Benefits, thank you. Thank you. From benefits manager to make sure,

MARCINIAK:

And we're here to help each other.

DEBLOCK:

Perfect. Right, to make sure that we're doing the right things with opioids. We've seen a huge drop in opioid use over the years. So I think when you have that and I mentioned the whole pharmacy card and the quick prescription refills...

MARCINIAK:

Yep.

DEBLOCK:

And what we do with them as far as getting the right prices on the pharmacy and making sure it's the right pharmaceuticals for the claimants and it's not being overprescribed by our doctors. It's a huge part of the claim. As these claims get older as well, and some of these claims that are lifetime claims, we keep on top of those as well through our pharmacy managers because of the fact that we don't want them staying on the same prescriptions for long periods of time, or do they still need it? Or are there ways to cut back in that prescription? And that all works together to help us, once again, mitigate those costs for our customer while making sure that our claimants are receiving the proper treatment. And that's the key right there.

How claims professionals stay ahead of emerging workers' compensation trends

MARCINIAK:

Yeah. And I know, with an ever-changing environment, what are some things that, that we do here at Zurich for our claims adjusters to ensure that they're in the know on some of these changing trends and what to look out for in terms of care for the injured worker?

DEBLOCK:

What's nice about working with Zurich and our vendors and our internal partners is the ongoing training that we have with our adjusters across the board, talking about these things like: What's coming up? How about migraine medications? How about GLP-1 drugs? Where does that fall into the workers' comp, going forward? Or is it compensable? Do we use those? What's the long-term term impact of GLP-1 drugs on the claimant? All those are important to us as we move forward with workers' comp and how we handle these claims.

MARCINIAK:

I've seen quite a bit of the training happening here at Zurich, and I always just wondered, like, how are we staying on top of all these trends? It feels like every day there's something new coming out. And you're right, with the vast network of vendors that we have and experts that we have, I think together, partnering on some of that training has benefited us.

DEBLOCK:

And not only that, you know, we are part of two organizations, WCRI, which the Workers' Comp Research Institute, and the CWCI, California Workers' Comp Institute, that we work with, who do studies and, like, supply data to us that allows us to further dig into these trends down the road and see what's going on. So it's great being part of the organizations as well.

MARCINIAK:

Yeah. And I know you are an avid attendant of a lot of their seminars and webinars and even speak on panels for both of those organizations. So, whenever I have a question on what's emerging, I'll just come and ask you, my expert.

DEBLOCK:

<laugh>. There you go. <laugh>.

Why return-to-work programs are critical to controlling claim costs

MARCINIAK:

So, you had mentioned previously return-to-work and the importance that that is, and really a goal that we have for our injured workers. Can you speak a little bit to how can return-to-work support help customers control workers' comp costs?

DEBLOCK:

So, when I look at what's the best way to have a good outcome on a claim, it really is getting that person back to work. It's more like that whole habit-forming thing. The habit becomes not going to work. So, the longer they're out, the more they become used to not being at work and receiving those temporary checks.

I think most people probably want to get back to work. They do. They just want the help and support to know that they're doing it the right way. Yeah, I think sometimes we hear more about the bad actors and the outliers versus what we experience probably more like 90% of the time, which is folks wanting to get back into their normal routine and back to a normal life.

If you can get an insured who has a great return-to-work program, get them back to work as quickly as possible, that's half the battle right there. And when it comes to having a program like that, it needs to be a written program. It needs to be used across the board evenly for all claimants. You need to have light duty in there, transitional duty. You need to have that so your managers are educated in how the program works. And if there's not one in place, I'm sure our risk engineering folks can work with our customers to make sure they are in place to make sure this gets all back, gets all backed down and working correctly.

MARCINIAK:

Is that an opportunity you see some of our customers having, or perhaps not having a strong return-to-work support plan?

DEBLOCK:

No. Our customer base, we do pretty well there. I think we look at other customers, even some of ours, who might be in a captive, for instance, where they're really a smaller business and the opportunity isn't there sometimes for them to have a real return-to-work program. That's where we can help, I think, because working with the customers like that, who don't have that program or as robust a program, to get folks back to work.

Workers' compensation trends employers should watch

MARCINIAK:

Awesome. You hit on something earlier, um, and I'll kind of paraphrase it as not going to work kind of starts to become their routine. And I think that's something that we saw, you know, shortly after COVID with just even coming into the office, right? Folks started getting a little accustomed to not coming to an office space to work, and then that became their norm. And I know, you know, there's been a lot of change management around that in the industry and outside with getting folks a little more accustomed to coming back to an office to work. So I'm going to ask you one last question, and it's kind of one about the future and what you're anticipating. But what trends should our customers be thinking about as they look ahead?

DEBLOCK:

So there's a couple that come to mind pretty quickly. One is medical inflation and where it's going. And I mentioned that earlier. Yeah. The modalities being used or how often they're treating for certain injuries are ones we're keeping an eye on. A big one that I actually spoke to at WCRI is the whole consolidation of medical providers across the nation and access to care in certain markets, particularly rural areas. Then you also talking about even like physical therapy and things like that. They're all consolidating and making it more and more difficult for claimants to get treatment. Those are the two biggest ones. I think if I were to throw a third one out there, it's more toward our more severe injuries. The traumatic, catastrophic ones. We're seeing, uh, more severity there on those claims just because of the fact that with technology and medical improvements, we're seeing those folks live longer, have better outcomes. But with that comes, of course, you know, a more severe claim and a higher cost down the road.

MARCINIAK:

Yeah. And that's something that was also discussed at the NCCI conference we were at earlier this year. And I'm just curious if there's a plug there for our risk engineers to connect with our customers on that topic to help drive loss costs into the future.

DEBLOCK:

The best actions, one that never happens, right? If we could prevent action from happening all better for us.

MARCINIAK:

Yep.

DEBLOCK:

And our customer.

Why timing matters when returning injured employees to work

MARCINIAK:

Win, win, win. So, Neil, how do our teams here at Zurich decide when an injured worker is ready to go back to work? How do we know it's the right time?

DEBLOCK:

It's not us deciding, it's actually the doctors deciding when someone goes back to work. We have very little input on whether or not, or what date they're going back or when they're going back or what capacity. We trust our medical facilities and doctors to determine what's right for each individual claimant.

MARCINIAK:

Based on the circumstances of their care plan, their job and really just the environment that they're in.

DEBLOCK:

All those you just mentioned. Yes.

MARCINIAK:

If you send somebody back to work who's not ready to go back to work, you're probably going to see them again being the injured worker. Um, it'll be more detrimental, I think, to the customer than trying to get someone back to work too soon.

DEBLOCK:

Exactly.

MARCINIAK:

Well, Neil, thank you for helping connect the dots between workers' comp managed care and the steps Zurich Claims takes to help customers reduce loss costs while also supporting our injured workers.

DEBLOCK:

Thanks for having me.

MARCINIAK:

And thank you for listening. In our next episode, we’ll take a deeper dive into how medical bill review helps drive better business outcomes, including the broader claims cost management story. Our guest will be Jesi Pabley, Head of Managed Care and Vendor Services at Zurich U.S. If you like the show, leave a comment or review wherever you get your favorite podcast. Or drop us a note at media@zurichna.com. This has been Future of Risk, presented by Zurich U.S.