important to understand the insurance
company’s rationale behind the reserves
and establish a consensus among all parties. Your broker’s claims advocate should
have a process and ability to challenge
and lower reserves. The process of reviewing workers’ compensation reserves
prior to the carrier reporting losses for an
experience modification rate is also critical. One mistake or over-reserved claim
can lead to a higher than accurate experience rate and premium.
4. A sound strategy should be detailed
with explicit target dates guaranteeing
progress towards resolution. It should
define who is responsible for the next
step and when it will be completed. The
strategy should be re-evaluated often to
maintain focus and accuracy. Remind the
carrier to pursue subrogation opportunities to lower the claims experience rate.
5. Target dates for resolution keep everyone focused on expectations for closure. As changes cannot always be prevented, target dates should be re-evaluated
based on present circumstances.
6. Insureds can offer valuable information to assist in claims resolution.
Often, the insured is the eyes and ears
on the ground level and the first to know
of changing situations. The insured also
provides information needed to adjust
the claim, such as wages.
7. Insurance adjusters obtain infor-
mation through the investigation of the
claim that could aid in the prevention of
future claims. Without being asked, this
valuable information can be lost.
Utilizing these steps can help get a
claim off to the right start and mitigate
problems later on in the process.
Jenean Meier ( jmeier@kmrdpartners.
com) is a claims advocate at KMRD
Partners, Inc., a nationally recognized
risk and human capital management
consulting and insurance brokerage firm.
of claims affects
loss experience and
eventually a company’s
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