Claims Management
Workers Compensation:
Workers Compensation is a cost every single business incurs but few truly understand. Accidents happen but it is what happens after the accident that can truly affect your bottom line. If your claims are not managed correctly and in a timely fashion, the final cost of a claim can end up being multiple times more than the actual cost. Neczus has developed a program managed by insurance professionals with decades of claims management experience. We review procedures in regards to handling Workers Comp Claims and help improve procedures and best practices Insurance carriers and sophisticated commercial clients make reducing claims leakage a priority. Some of the quantitative and objective factors assessed by claim auditors include:- Duplicate and over payments
- Timeliness of contact
- Closing ratios
- Caseload numbers and
- Recoveries
Factors Likely to Drive up Claims Costs
What many auditors without hands-on adjusting experience miss, however, are the qualitative factors that likely cause the greatest leakage in claims handling. These factors include:
- Untimely assignment of or lack of nurse case management
- Inadequate medical management
- No clear return-to-work process and no job coaching
- Little interaction with the injured employee once he or she is disabled
- Use of low-cost medical providers who deliver poorer outcomes and
- No clear litigation plan once litigated
These measurements are more subjective. A highly experienced claims consultant can provide the needed insight to ensure your carriers properly manage your clients’ workers’ compensation claims.
When your carriers do not provide best in class claims management, it hurts not only your insureds’ profits, but your brokerage’s profits, as well. How is the agent or broker to know which claims are handled effectively and which need a new approach?
A claims consultant provides oversight to the workers’ compensation claims process. This oversight helps to ensure your clients’ employees receive stellar medical care, return to work swiftly in some capacity, and develop a strong treatment plan for those employees who do not reach maximum medical improvement. Only by focusing closely on each problematic injury claim, even seemingly minor incidents that can morph into major injuries, are insurers able to reduce leakage and claims’ spend. Unfortunately, today’s insurers don’t always manage claims in this manner.
Working hand-in-hand with your clients, we can assist them in developing internal procedures and provide training so that, with input from us, they can better manage injury claims from first report to conclusion. With strategic claims oversight, we can improve your clients’ and your brokerages’ bottom line.
