I had lunch with a nurse case manager not too long ago and we were discussing misdiagnosed …
TPA and Claims Administration
Important Points to Include in Account Handling Instructions
Account handling instructions inform insurance adjusters on how to handle a company’s workers’ …
Important Points to Include in Account Handling InstructionsRead More
Ethics In Insurance Claims Negotiations
In the fast-paced world of workers’ compensation claim management, we are challenged on a daily …
What Is Your Workers Compensation Claim Worth?
Risk managers frequently ask “what is the claim worth” when trying to get an idea of the long term …
Why A Simple Slip And Fall Claim Is Not So Simple
I think a lot of adjusters believe that a slip and fall injury is an open/closed kind of case. The …
Breakdown in Communication and Expectation Leads to Claim Disasters
Pretend for a second that this is a headline/title of an article in a …
Breakdown in Communication and Expectation Leads to Claim DisastersRead More
Undocumented Workers Eligible for Workers’ Comp Benefits
In November, 2013 the Iowa Supreme Court ruled in the case of Staff Management v. Jimenez that …
Undocumented Workers Eligible for Workers’ Comp BenefitsRead More
Never Give Up – The Mantra of an All Star Work Comp Adjuster
Too often adjusters will perform a background check, medical record sweep, or run an ISO sweep* …
Never Give Up – The Mantra of an All Star Work Comp AdjusterRead More
Poor Documentation Makes Claims Handling 100x More Difficult
File notes and goals are becoming extinct. Realistically, the only way to move a file …
Poor Documentation Makes Claims Handling 100x More DifficultRead More
Your IME Doctor Selection Can Make or Break Your Case
A common error I notice in work comp files are adjusters choosing the wrong IME doctor. Sure …
Your IME Doctor Selection Can Make or Break Your CaseRead More
Make Sure Injury Is Work Related Before Approving Treatment
The wise workers’ compensation adjuster during the initial investigation of the claim ties down the …
Make Sure Injury Is Work Related Before Approving TreatmentRead More
Why Train New Hires When They Will Just Quit Anyway?
To date, I have yet to meet anyone that planned on being a claims adjuster. Think about that for a …
Why Train New Hires When They Will Just Quit Anyway?Read More
We Are Getting Worse at Dealing with Back Pain
I was reviewing an article that was of no surprise to me: Insurance companies are getting even …
Is Your Workers Comp Claims Supervisor Being Held Accountable?
In a perfect world, everyone is held accountable for their actions. Not only in life outside of …
Is Your Workers Comp Claims Supervisor Being Held Accountable?Read More
Proper Compensability Investigation Stops Claim Before It Starts
Many rookie adjusters get ahead of themselves. This probably should not be seen as a surprise, …
Proper Compensability Investigation Stops Claim Before It StartsRead More
Self-Insured Employer Must Confirm TPA Has Customer Service Guide
Every self-insured employer should confirm their third party administrator (TPA) has a Customer …
Self-Insured Employer Must Confirm TPA Has Customer Service GuideRead More
Workers Compensation Claim Handling Standards
Self-insured employers have more leeway in establishing and controlling the quality of claim …
Try Not To Be So Optimistic When Reserving A Work Comp Claim
Contrary to popular belief, sometimes adjusters are optimistic when reviewing their open cases. …
Try Not To Be So Optimistic When Reserving A Work Comp ClaimRead More
Understanding and Defending Occupational Disease Claims
Understanding and Defending Occupational Disease Claims Employers who are not in the mining …
Understanding and Defending Occupational Disease ClaimsRead More
How To Stop (or slow) Adjuster Turnover at Carrier/TPA
Back in the 1980s it seemed like adjusters settled down right when they were hired. Most spent …
How To Stop (or slow) Adjuster Turnover at Carrier/TPARead More
