Ask Jen Robertson what’s changing in disability claims, and she starts not with technology, but with the first interaction. That initial contact—especially within the first 30 days—can shape the entire trajectory of a claim, influencing claimant engagement, recovery momentum, and overall duration.
Historically, the industry has focused heavily on processing speed. But according to Robertson, AVP of disability claims at Co-operators, this early window is where outcomes, costs, and trust are truly determined. “How a claim is handled in the first 30 days will strongly influence the claimant’s engagement… and the duration of the claim,” she explains.
The nature of disability claims has shifted significantly over the past decade. Rising mental health cases, increasing psychosocial factors, heightened regulatory scrutiny, and stretched claims teams have transformed the landscape. What was once considered complex is now standard.
“Complexity isn’t the exception, it’s the baseline,” Robertson says.
This shift challenges operating models built on standardization, where complex claims were treated as exceptions. Today, success depends less on scaling processes and more on scaling decision quality.
“What separates strong organizations now is whether they are scaling a process or scaling elevated decision quality,” Robertson notes.
Mental health claims are putting traditional disability models under pressure. Unlike many physical claims, they are less predictable and rarely follow a linear recovery path.
“Mental health claims are different, they’re less linear,” Robertson explains.
Factors such as workplace dynamics, treatment access, and fear of relapse all influence outcomes. Two individuals with the same diagnosis may experience vastly different functional impacts depending on their environment, role, and support systems.
As a result, carriers are investing in stronger early engagement, clinical literacy, and proactive risk identification to prevent claims from stalling or “drifting.” Psychological safety—ensuring claimants feel understood and respected—has become a critical driver of engagement.
A key risk in modern claims handling is over-reliance on automation and standardized processes at the expense of human connection.
“If a disability claim becomes overly transactional, we’ll see unintended consequences,” Robertson warns.
Disengaged claimants are more likely to experience longer durations and poorer outcomes. When individuals feel misunderstood, recovery slows, compliance drops, and claims can derail entirely.
“A disengaged claimant is rarely a short-term duration claimant,” she says.
While “people first” is a common phrase, in disability management it requires structure and discipline. It means grounding decisions in clinical evidence—diagnosis, function, and treatment—while maintaining clarity, consistency, and dignity in communication.
Importantly, it’s not about lowering standards.
“People first is not about softer adjudication, but more proactive adjudication anchored in recovery,” Robertson emphasizes.
This approach also helps prevent “drift,” where claims continue without a clear recovery path, increasing costs and weakening outcomes.
If complexity is the baseline, engagement is what ultimately drives results. Engaged claimants are more likely to share information, follow treatment plans, and collaborate on return-to-work strategies.
Conversely, disengagement—often caused by overly transactional interactions—leads to delays, longer durations, and increased escalation risk.
Outcomes are also shaped by a broader ecosystem; Advisors influence plan design and expectations; Employers impact workplace accommodations and early support; Carriers drive adjudication quality; and vendors guide treatment pathways.
Plan sponsors are increasingly seeking partners who can improve outcomes across this system, not just process claims efficiently.
The industry’s definition of success is evolving. While claim duration remains important, it is no longer sufficient on its own. The focus is shifting toward metrics that predict durable outcomes like claimant engagement, decision consistency and sustainable return-to-work.
Optimizing purely for speed can lead to premature closures or recurrence, Robertson says. Future success will be measured by the quality of the claimant journey—not just how quickly a claim is resolved.
In today’s more complex environment, the organizations that excel will be those that prioritize early engagement, elevate decision quality, and maintain a human-centered approach—recognizing that the first interaction can shape everything that follows.
This article was produced in partnership with Co-operators
