Avoiding the Top 7 Mistakes with WC Insurers

The insurance company or third-party administrator that administers workers’ compensation claims has a huge impact on return to work and the ultimate cost to the employer, according to www.reduceyourworkerscomp.com.

The site lists the seven biggest mistakes employers make:

1. Not visiting the claim offices and sitting “chair-side” with an adjuster. You must see the process first-hand to understand how your claims are handled. Then, you can integrate your processes into services your insurer offers.

2. Not meeting with all service providers. Since your program depends on medical providers, investigators, law firms, medical-bill-audit companies and other vendors, you should see examples of their reports and understand their fees. Meet them at the start of the relationship and periodically thereafter.

3. Not having on-site file reviews regularly and not attending reviews. Only you know if the worker is still employed and if he or she had other problems at work that might be relevant.

4. Not using an MD to review medical records and reports but relying on adjusters to make medical decisions. Doctors are better qualified than nurses or adjusters to determine what information is missing in a file or whether there are other possible causes of an injury. Having an MD review the file before causality decisions are made or before independent medical examinations are ordered is crucial.

5. Not customizing account handling instructions. If you want settlement authority or want to be involved in selection of counsel, put it in writing. Find a beginner’s list of what should be in your account instructions at: http://blog.reduceyourworkerscomp.com/?p=74

6. Not staying involved. Many employers abrogate responsibility for their employee’s medical care and return to work, relying on the claims adjuster. Employers are responsible for what happens to their employees after the injury. You must take charge.

7. Not getting any assistance from your broker. Your broker has worked with hundreds of similar situations, so use that to your advantage and include them in the claims handling process. Have them set up reviews, help select file parameters and offer suggestions for “next steps” in a claim. The broker can help head off problems proactively, not just in difficult claim situations when things have gone wrong.

It’s easy to avoid these mistakes. All forms and documents employers need are in the “Working with the Insurance Company” module of www.reduceyourworkerscomp.com.