Work Comp Claims Management

This is the second installment of The Seltzer Group’s Workplace Injury Best Practices Series! This is part one of three for the month of February. Check back next week for part 3!

Accurately understanding the financial impact of workplace injuries is a critical first step to managing your overall insurance costs.  In the last Workplace Injuries Best Practices Series article, Exposing the Cost of Workplace Injuries, it was explained how Work Comp injuries cost employers as much as 3X the amount of a claim in the form of direct premium surcharges.  Once an employer or management team grasps the basis of why this happens they want to know how they can improve outcomes for their companies.

One of the best ways to accomplish this is through claims management.  Effectively managing your Workers Compensation claims isn’t easy, but it is a realistic and achievable goal. In fact, it’s almost impossible to do on your own without the specialized training and education.   Most employers realize this, so they go to the most logical place for answers- their insurance company and broker- for support.  Unfortunately, most claim adjusters maintain a case load of 150 to 200 claims, hindering their ability to provide the level of care and attention that your claims deserve.

Not all brokers are qualified to effectively manage claims because they do not have the required training, expertise or knowledge. Some brokerage firms may have ability to assign an employee to oversee claims and track information, but they are usually not able to proactively manage and navigate your claim. This is vital necessary to drive down your costs and prevent expensive mistakes.

The Seltzer Group along with East Coast Risk Management, built a staff of knowledgeable and experienced Work Comp Claims Adjusters who work on behalf of you, our employer clients, not the insurance company.  Once engaged, our dedicated claims team becomes an extension of your company.  Here is a sample of what they do:

• Manage all claims from start to finish to control costs, prevent fraud and abuse and eliminate expensive mistakes that commonly go undetected during the claim process

• Design, implement, train and oversee a Return to Work program that is suitable for your business

• Guide injured employees through the complex work comp system by explaining the rules, assisting with scheduling of doctor appointments and notifying them of their expectations throughout the claim process

• Communicate with attending physician to get up-to-date diagnosis allowing us to proactively manage your claims while eliminating wasteful and costly delays

• Mitigate unnecessary and costly (time and money) litigation and maintain powerful documentation for a strong defendable position in the event a case does go to court

• Coordinate and work with your HR department and safety personnel

• Continually communicate with injured employees, your supervisors, treating physician(s), and insurance company

• Substantiate and confirm that you insurance company is setting fair and reasonable reserves

• Verify proper and timely claim closures

• Preserve your rights to claim recovery and file appropriate forms to obtain premium refunds for your company

If your company is experiencing even just a few Workers Compensation claims a year and if you are relying on your insurance company or broker to manage them, there is a good chance you are being charged thousands of dollars a year in additional premium.  As an employer you have the power to take control and reduce or eliminate these excessive charges.

For more information about Claims Management or to receive your free Workers Compensation Financial Report, contact us at 888-366-1000.

Work Comp Claims Management was last modified: August 26th, 2014 by Sarah McGorry