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Timeliness and thoroughness of claims reporting is the primary method to lower the cost of a Work Comp claim on a per accident basis. Providing the insurance company with accurate information quickly will ensure claims are handled promptly and appropriately. If the insurance company does not know the specifics of the accident or if the First Report of Injury is not submitted immediately, claims tend to drag out, leading to larger Work Comp payouts and a higher Work Comp premium. Minor claims have the potential to blow up into these large losses when employers do not have an established and organized claims process. Those who have an efficient claims procedure are paying anywhere from 25%-50% less than their peers. Here are a few aspects of an ideal claims process and the matters it ought to address:

  • It is crucial that the employer educates supervisors and other employees on the claims process before an abrupt injury occurs, this preparation will ensure that the claim is handled in an appropriate and efficient manner.
  • The claims process must be designed to fit your respective organization, designate and train an employee(s) as a claims coordinator who will be responsible for initiating and executing the claims process.
  • Each injury must be assessed as to whether it requires emergency medical care, or if the injury is less severe or minor, the injured worker must be immediately taken to your company’s occupational clinic in order to determine the extent of the injury. Whether an injury is severe or minor, it is imperative that the injury does not go unnoticed. The injury must be addressed immediately in order to prevent the employee from further aggravating their injury.
  • Following the occupational clinic’s assessment of the injury, it is crucial for the employer to remain focused on a stay-at-work solution, rather than having the worker out for an extended period of time on Work Comp. Create a list of duties which the injured employee can fulfill that takes the employee’s physical limitations into account. It is typically two or three times more expensive to have an employee out on Work Comp, than it is to pay their salary while they do a different job with a smaller pay scale.
  • Supervisors/managers must now make the decision as to whether the Work Comp claim ought to be filed, reviewed with employer’s respective insurance agency, or to not file the claim at all
  • Shortly after the claims coordinator notifies a manager/supervisor of the injury, there must be a process in place that completes the required OSHA logs, claims reporting, and post-accident review.
  • It is extremely important that the employer demonstrates empathy for the injured party and expresses concern for the employee’s well-being. Expressing how valuable an employee is to your business and wishing them a speedy recovery goes a long way towards encouraging the employee to promptly recover and return to the workplace.

These are just a few features and benefits of an ideal claims process. The first step toward ensuring that a claim is handled swiftly and as least costly as possible is to institute a well-managed claims process. Those that have such a procedure in place are minimizing the costs of work comp claims and are seeing their workers return to a work at a much quicker rate. Have you dealt with or are dealing with costly claims that are dragging on longer than expected? Call Knight-Dik Insurance Agency, Inc. at (508)753-6353 for more information on Massachusetts Workers Comp Insurance.

Rami Dalli, CWCA

“The Workers Comp Guru”

Posted 12:31 PM

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