All of your claims can be called in directly to the claims administrator, but if this is the first time you have had a claim (or it has been years), you may need a refresher on how to report, what forms need to be completed and the steps to follow. This is particularly true with workers’ compensation claims where prompt reporting is essential to controlling the claim cost. Our Claims Consultants can guide you.
Assisting customers in monitoring and managing their Workers’ Compensation, Auto, Property and Liability claims
This involves acting as a liaison between our customers and the claims examiners often by facilitating communications. Since you report claims directly to the carrier/claims administrator, we ask that you notify us of any claims of particular concern to you – perhaps claims with disputed injuries; contested claims; or potential fraud to name a few.
Claims examiners assigned to our claims generally do an outstanding job of adjusting our claims. However, there are times when we don’t see eye-to-eye with the examiner handling a claim, and in those instances, we will be your advocate and hold claims examiners accountable for maintaining appropriate action plans to resolve the claim.
WC Claim Reserve Audits
Our Claims Consultants monitor WC claim reserves to ensure that reserves established are reasonable and based on probable outcomes of claims. In those situations where reserves are excessive, we will negotiate appropriate reserves with the carrier/administrator. This helps reduce future premiums.
Experience Modification Analysis and Projections
Approximately 50% of our customers qualify for WC X-mods. For those customers who qualify,
we review your X-mod for accuracy and can provide an analysis for you of the claims that are impacting your x-mod. We can also project your future x-mod for you to use in budgeting and forecasting.
Our Claims team will help you understand the complexities of the claims process. WC has unique opportunities to mitigate claim costs including prompt reporting of claims, proper implementation and use of the MPN process, and Return to Work programs. In addition, our Claims Consultants will help you to better understand the medical treatment and legal processes, plus benefits available within the WC system.