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Injury Management Guide
CARE: Concerned About Recovery of Employees ©
Claims Management Guide
The function of the Claims Management Guide is to steer employers through the process of handling workers’ compensation claims.
This is a written program which provides all needed forms to communicate the Claims Management Program to Supervisors and Employees. Also, it gives you the actual forms to notify adjusters of issues and to notify workers of available work.
You have a Safety Program to prevent injuries. However, accidents may occur inspite of your best efforts and when they do it is in your best interest to handle the claim in such a way that will result in quality care for the injured worker and prompt return to work.
The FBI estimates that 10 percent of insurance claims contain some element of fraud.
The cost of Workers’ Compensation Insurance is an ongoing expense to the organization and it should be lowered it to the lowest possible level.
To control cost you should prevent malingering, abuse, fraud and expedite Return to Work.
According to the National Council on Compensation Insurance (NCCI) the later a claim is reported to the employer/carrier the more it cost. Late reporting drives up your Experience Modification Factor. In fact, a study conducted by the Hartford Insurance Company found that claims filed 5 or more days after an incident / injury increased the claim cost by 15%, verses similar claims filed promptly.
This claim management tool gives you the information you need to speak knowledgeably about the claims handling process and the specific actions that can be taken to reduce the cost of the case.
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