Tips for Managing Workers Comp Claims
The single most effective method of controlling workers' compensation costs is to maximize safety in the workplace. This must be a priority item for top management, and the concept of safety must be passed down from the top through the entire work force.
A safety program should be implemented which includes a policy statement outlining safety expectations and the evaluation of your entire business operations, from hiring to training to workplace safety.
With the positive commitment of top management, the success of the safety program will be greatly enhanced. Job-related injuries, however, are still going to occur, and when they do, an operational plan must be in place in order to respond to the needs of the injured employee.
Communication is a key to the effectiveness of any safety program and employees should be aware of the goals of the program. To be successful, the components of the plan must be clearly communicated and defined to management and employees alike, and should become a part of your management process.
Employees must be aware that they should report any injury as soon as it occurs and to cooperate fully with the plan. Prompt reporting of the injury will not only enable management to take the required steps to respond to the injured employee but will also allow timely notification to your insurance carrier, which can be a significant factor in controlling the cost of the claim.
Workers Comp Operational Plan Essentials
1. Establish a Case Management Team with a Team Coordinator. The team coordinator will maintain contact with injured employees and coordinate and monitor medical treatment.
2. Employees Should Be Contacted in Person or by Phone Within 24 Hours of Injury. Assure employees of the company's commitment to ensuring effective medical care and helping them return to work.
3. Identify and Select, or Develop a List of Preferred Providers to ensure that injured workers are treated by professionals experienced in occupational injuries.
4. Develop a Written Job Function Evaluation for Each Employee that can be provided to treating physicians to help them determine the suitability of alternative job tasks which may allow the injured employee to return to work with a temporary medical restriction.
5. Establish an Early Return-to-Work Program. These programs allow injured employees to assume light-duty work assignments as soon as they are able.
6. Promptly Report All Workers' Compensation Injuries to Your Insurance Carrier and work with your claims representative in the management of the claim.
Quick Responses Also Reduce Total Costs
While the benefits of safety and loss prevention programs are mostly self-evident, they only represent half the battle in the war on workers' compensation costs. Minimizing the severity of accidents that do occur is of equal importance.
Some business insurance studies show that for each day that passes between the date of injury and the date case management begins, the duration of the claim increases by 2 1/2 days. In other words, if it takes an average of two weeks before your claims adjustor can begin working on your workers' comp cases, the cases will typically last more than a month longer than if immediate intervention is employed.
Workers' Compensation Quick Response Checklist
- Telephone or fax all first reports of injury to the carrier or adjustor immediately after the incident occurs. Don't delay while waiting for medical reports, bills, etc.
- Minimize the number of people in the loss reporting process. Provide for direct notification from the worksite to the adjustor rather than channeling the reports through a main office. Establish procedures for using back-up personnel to report losses when the person who is primarily responsible is unavailable to do so.
- Work with your insurance company to assist in gathering subsequent information helpful in minimizing the loss. Help them understand the employee's job requirements, how the accident happened, and what modified work you have available.
- Stay in touch with your injured employees, reminding them they are a valuable part of your team, and asking them what you can do to help speed their recovery.
- "Stop the Bleeding" in the emotional and financial aspects of the work-related injury; don't just relieve the physical pain.
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Source: National Association of Convenience Stores
American Benefit Advisors, Inc.
Atlanta, GA 30077-2166
Phone 770-645-5989
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