What the Employer can do to reduce the exposure to of Workers Compensation costs before and after a claim.

Transcription

1 What the Employer can do to reduce the exposure to of Workers Compensation costs before and after a claim. Presented by Robert Rice Sargeant Insurance Agency, LLC.

2 This presentation is intended to provide some techniques to reduce the exposure and cost of Workers Compensation. This discussion is not intended to be legal advice but a sharing of information from personal experience and the experience of others. Consult an attorney or insurance professional regarding any specific issue confronting your business.

3 35+ years as an insurance professional 35+ years appearing before the WCAB 25+ years as a licensed private investigator 25+ years as a certified self-insurance administrator 4 years as a licensed property casualty agent 30+ years as a small business owner

4 Safety!!! Medical Provider Network Return to work-modified or alternate duty Investigation Communicate with insurance carrier Documentation

5 Safety!!! Have a written and enforced safety program intended to provide employees a DIRECT FINANCIAL INCENTIVE Measure the employees success or lack of success in controlling injuries/accidents Lead by example Instill a positive health and safety culture Ensure that employees are involved in the decision making process

6 1. Employees become more focused on their work 2. Participation motivates employees to contribute more. 3. Participation in decision making can help employees to become more accountable 4. Demonstrates that you care about them

7 Near misses and resulting inspections may help prevent an injury or even a fatality, but an investigation cannot take place if the near miss is not reported accurately. Therefore, setting up a successful safety management program to ensure near misses are reported and investigated is an important step in reducing occurrences of serious incidents

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9 Gives the employer/insurance carrier unlimited medical control. Doctors are trained in reporting requirements Doctors are usually more accessible to the employer s input Better opportunity for prompt return to work Significantly reduces medical costs in a litigated case.

10 At the time the employee is hired or when a new insurance carrier is obtained the employee(s) must be notified of the employer s MPN. In English and in Spanish (required) Include a Predesignation Form, in English and Spanish. Have the employee sign the acknowledgement form which should also be in English and Spanish and signed in their native language Take a photograph of the employee holding the MPN packet.

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15 Facilitate returning injured workers to work Offer modified or alternate work Does not have to be enjoyable or permanent Should have to have some benefit to the employer Create modified or alternate work job bank and written job description for each Always communicate with your employee and the doctor(s) in writing that alternate or modified work is available. Keep your insurance adjuster informed of modified or alternate work availability

16 Prompt internal investigations are crucial Disputed claims need an aoe/coe investigation This starts with the Employer investigation and documentation Recommend Surveillance investigation early in the claims process The insurance carrier far too often waits to undertake sub-rosa investigation. Provide them a reason, in writing, as to why surveillance would be beneficial FRAUD?

17 Monitor the claims activity Push disputed cases to a prompt disposition including Trial Monitor reserves and claim closure DO NOT DEPEND ON THE INSURANCE COMPANY TO ALWAYS PUT THE EMPLOYER S INTEREST FIRST

18 The common HR rule is to document everything Serves you very well in Workers Comp Employer can seek relief from the insurance carrier for improper claims handling Should a case go to Trial, you as the employer are prepared to influence the Judge

19 Thank you for your attention!! Robert Rice Sargeant Insurance Agency, LLC.