Cold winter nights and non-stop snow storms across the country should not delay claim management teams from preparing for springtime. Now is the time to do some “spring cleaning” in your claims management program to make sure you are ready for summer. Part of this process includes a complete review of your program to ensure efficiency and effectiveness.
Know the Goals of Your Clients
Everyone talks about “meeting the goals” of your clients. Do you really know what those goals are? The process starts with meeting with your clients to better understand what they are trying to fix, accomplish or avoid. This will allow your team to concentrate their efforts on these areas to meet – and hopefully exceed their expectations. Common themes can include:
- Complete Required Documents in a Timely Manner: Members of the claim management team are required to perform a number of functions in a timely manner. This includes the prevention of unnecessary costs associated with administrative penalties, excessive litigation costs, and delayed return-to-work.
- Avoid Communication Breakdowns: Workers’ compensation claims are driven by information. Not having correct and accurate information results in time lost by individual claim handlers. Physical and psychological barriers need to be removed so all interested stakeholders can communicate in an effective manner.
- Full Regulatory Compliance: The workers’ compensation system is driven by the details. This includes ever-changing requirements on when, how and where forms are to be filed.
Implementation of Claim Management Decisions
Proper execution of a client’s decisions is essential when running an effective claim management team.
- Empower all team members to make decisions: Surround yourself with people who exercise good judgment and make informed decisions.
- Keep the goals and objectives of the client, and keep them in mind at every decision. This includes using preferred service providers when necessary and a willingness to make recommendations.
- Be a zealous advocate for the claim – integrity is key! Treat all injured employees with respect and dignity. This can be accomplished by returning calls in a timely manner and making all decisions in good faith. Never cut corners or try and save a buck by issuing frivolous denials.
Coordinate Efforts on Risk Assessment
There are numerous ways claim management teams can be involved in the risk management process. Key areas to focus on include the following:
- Preparing effective job descriptions: There are a number of challenges employers face when engaging in the hiring process by the posting of an open position. Potential barriers include the American with Disabilities Act and other affirmative action considerations. A proper job description should be written in a comprehensive manner that includes the ability to accommodate all prospective employees.
- Interviewing process: This part of the hiring process is fraught with dangers that lurk in every question asked of a candidate. During the interview process, it is important to focus on someone’s experience, training, and planning ability. It is also essential to set the right tone when it comes to workplace safety.
- Global Settlement and Release of Employment Claims: Seeking a voluntary resignation and release of all employment claims is often a term of settlement employers request when settling a workers’ compensation claim. While employees are a valuable asset, seeking their resignation of employment can be a tool to reduce future exposure and limit liability. Consultation with an attorney who understands employment law issues is important when making these requests.
Review of Return-to-Work Policies and Procedures
Countless studies indicate that returning an employee back to work following an injury pays dividends. It is important for employers and other interested stakeholders to be fully invested in these measures as part of their workers’ compensation programs. This should not be limited to returning an employee to work with the date of injury employer. Other considerations should include the Ticket To Work program and “work to loan” efforts.
Spring is in the air – now is the time to review one’s workers’ compensation program. This includes a proactive claim management team meeting with their insureds and better understand their goals. Suggestions can also be made when it comes to assessing risk and getting injured employees back to work in a timely manner.
Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .
Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/
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