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Comment by tcarn | Hacker News Reader

Former Workers Comp claim examiner here.

Every Workers' compensation insurance company hires private investigators to make sure the person is really injured and not working another job while collecting. Sounds like the private investigative company overstepped their bounds by physically assaulting the worker, but otherwise this is SOP.

Worth noting - Amazon has nothing to do with this. They simply pay premiums for Sedgewick to administer the claims. The employer typically doesn't tell the insurer to go after the workers, since in this case it is Sedgewick who's footing the bill.

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> Worth noting - Amazon has nothing to do with this. They simply pay premiums for Sedgewick to administer the claims. The employer typically doesn't tell the insurer to go after the workers, since in this case it is Sedgewick who's footing the bill.

You are vastly understating Amazon's role here. Sedgwick is an administrator (TPA), not an insurer. Amazon is big enough that they will be self-insured for workers' comp claims. It's Amazon's money on the line for claims, not Sedgwick's, so Sedgwick will do whatever Amazon tells them to do for claim processing even if it was reckless and stupid.

> Worth noting - Amazon has nothing to do with this

Oh but article saying "Socialist party website claims investigator for $INSURANCE_COMPANY_NOBODY_KNOWS overstepped their bounds by touching someone's hand" is not going to gain as much clicks as fashionable Amazon-bashing! No chance to get to HN either.

> Amazon has nothing to do with this

Amazon surely incentivizes Sedgewick to reduce costs. Just like Amazon micro-manages every other warehouse aspect to wring out maximum efficiency.

The most anyone can really expect of them is that they consider other providers, or hold their existing providers to a higher standard; and that is almost certainly what they are going to do.

I mean with all this publicity they will probably be switching providers or sending in a complaint to Sedgewick, but they aren't micromanaging carpal tunnel workers comp claims that make up 1/100000th of their revenue.

Are there incentives for discovering a claim as fraudulent -- or do they just get paid by the hour, with certain standards that must be met, and that's it?

When they were choosing a claims management provider, they surely took care to choose one that aligns with their values. So this at least reflects poorly on Amazon's choices at that time.

You expect Amazon to interview insurance companies and reject any which answer in the affirmative to "do you follow industry standards with regard to investigating claims"?

> Amazon has nothing to do with this. They simply pay premiums for Sedgewick to administer the claims.

Amazon chooses to employ Sedgewick. When they learn of this kind of abusive behavior, they can switch insurers, or hell just threaten to switch. Amazon has all the leverage here, to abdicate them of all responsibility is absurd.

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