When employers evaluate a Third-Party Administrator (TPA), they usually focus on outcomes they can measure easily: claim costs, closure rates, compliance scores, and service timelines. What often gets overlooked is the condition of the people managing those claims day in and day out.
Burnout in claims teams is one of the most under-recognized risks in workers’ compensation. It does not show up on a proposal spreadsheet, but it directly affects claim outcomes, injured employee experience, and long-term program costs.
For risk professionals, understanding this connection matters more than ever.
Burnout is Widespread in Claims Operations
Claims adjusting consistently ranks among the most stressful roles in insurance. Examiners manage high volumes of emotionally charged cases, strict regulatory deadlines, constant documentation requirements, and frequent interaction with injured employees, attorneys, and medical providers.
Industry data reinforces this reality:
- Studies across insurance and claims roles show burnout rates exceeding 50% in high-volume environments.
- The U.S. Bureau of Labor Statistics continues to report annual turnover rates in insurance claims roles well above the national average for professional occupations.
- Research from Gallup consistently shows that burned-out employees are 63% more likely to take sick days and 2.6 times more likely to actively seek a new job.
In claims organizations, burnout becomes an operational risk.
What Burnout Looks Like Inside a Claim File
Burnout rarely results in one dramatic failure. Instead, it shows up through subtle but costly patterns:
- Delayed action on medical requests or benefit payments
- Inconsistent communication with injured employees and employers
- Missed opportunities for early return-to-work coordination
- Documentation gaps that increase audit exposure or litigation risk
- Higher attorney involvement due to frustrated injured workers
Each of these issues adds friction, cost, and time to a claim. Over hundreds or thousands of files, the impact compounds quickly.
Examiner Turnover is a Hidden Cost Driver
When a claims examiner leaves, the cost is not limited to recruitment and onboarding. The real disruption happens inside the claim files.
New examiners inherit open claims without historical context. Relationships with injured workers, supervisors, and medical providers reset. Strategic decisions made earlier in the life of a claim may not translate clearly to a new handler.
Industry estimates suggest that replacing a skilled claims professional can cost one to two times their annual salary, with lost productivity, training time, and disruption factored in. More importantly, claim outcomes often deteriorate during these transitions.
For employers, frequent examiner turnover can mean:
- Longer claim durations
- Higher litigation rates
- Reduced employee trust in the process
- Increased internal workload for HR and risk teams
Why Examiner Stability Matters to Employers
Stable claims teams produce better outcomes. This is not a soft benefit. It is a measurable advantage.
Experienced, supported examiners are more likely to:
- Identify compensability issues early
- Engage injured employees with empathy and consistency
- Coordinate effective return-to-work plans
- Spot cost drivers before they escalate
- Maintain clean, audit-ready files
From an employer’s perspective, examiner stability translates into fewer surprises and more predictable results.
The Athens Perspective: Managing Burnout Before It Starts
At Athens Administrators, burnout prevention is not treated as a wellness initiative. It is treated as a core operational strategy.
That starts with manageable caseloads. Claims examiners cannot provide quality outcomes when files are overloaded. Balanced caseloads allow examiners to think strategically, communicate proactively, and stay ahead of deadlines rather than constantly reacting to them.
It also includes low turnover by design. Examiner stability is supported through training, mentorship, and realistic performance expectations. The result is continuity for clients and injured employees alike.
This approach benefits everyone involved:
- Employees experience less stress and more career longevity
- Clients see consistent handling and fewer handoffs
- Injured workers receive clearer communication and faster resolutions
While many TPAs talk about technology or scale, examiner stability remains one of the strongest predictors of claims success.
What Risk Leaders Should Ask Their TPA
Burnout is not always visible from the outside. Asking the right questions can uncover meaningful differences between TPAs:
- What is your average examiner caseload?
- What is your claims staff turnover rate?
- How do you support examiners on complex or high-exposure claims?
- How often do claims change handlers?
- How do you measure examiner workload sustainability?
The answers reveal far more than a glossy brochure ever could.
The Bottom Line
Burnout in claims teams is a risk employers rarely see, but often feel through higher costs, slower resolutions, and frustrated employees. Examiner stability is not just an internal staffing metric. It is a critical component of effective claims management.
For risk professionals evaluating a TPA, understanding how claims teams are supported is just as important as understanding how claims are reported or reserved.
Strong outcomes start with people who are supported, experienced, and positioned to succeed.