On-the-Ball Injury Management Lowers Reserves and Saves $$$
The insured is a new home contractor.
An employee suffered a laceration to his finger while using a saw. The carrier set the highest possible reserves for disfigurement, permanent loss of use, and temporary disability warranted for this type of injury.
Knowing that insurance carriers routinely set high reserves on claims and keep those reserves active until the claim is closed, a Certified WorkComp Advisor (CWCA) resolved to keep close tabs on every aspect of the claim. Along with skilled in-house claims specialists, the CWCA worked with the employer, medical providers and claims adjusters to continually assess the case and adjust reserves accordingly.
As soon as the employee was released to full duty, the CWCA asked the insurance carrier to remove any remaining reserve for disability. A short time later, the carrier made a payment to the employee for scarring, and the CWCA requested they remove any remaining reserves for disfigurement. Later, the CWCA argued successfully to lower reserves for permanent loss of use.
By the insured’s next valuation date, reserves on this claim had been lowered by more than $57,000. As a result, the client’s experience mod rating was 19 points lower than it otherwise would have been. This translated into a premium savings of more than $4,000.