Insured
This assembler of office furniture employs 86 and has revenues
in excess of $32 million annually.
Situation
The employer saw its Experience Mod escalating steadily up to
1.22.
Assessment
Certified WorkComp Advisors (CWCAs) found that one reason for
the increase in the Experience Mod was the claim reserve for
an employee who suffered a shoulder injury, resulting in numerous
surgeries. Based on the extent of the injury, the carrier set
a loss reserve in excess of $100,000, resulting in an increase
in the Mod.
Solution
Upon researching the case, it was determined that even though
the claim was actually settled for $19,000, it remained on the
books at $100,000. The CWCAs had the insurance company reopen
the claim and re-file it with the state in order to have the
lower amount reflected on its state Experience Mod worksheet.
Result
With the identification and correction of this error, the company
saw a 22% drop in its Experience Modification Factor from 1.22
to 1.0, lowering its annual premiums by $6,000-$7,000.
