The Stakes: A metal fabricator was suddenly hit with a rash of carpal tunnel claims, including two costing over $80,000. Their Experience Mod skyrocketed to 1.72, and their carrier cancelled them. The company was facing an existential threat from spiraling premiums.
The Investigation: The Advisor analyzed the claims and found a pattern. The first claim was legitimate, but the subsequent ones were questionable “copycat” claims that had been approved because the company lacked clear policy language to address them.
The Breakthrough: The Advisor rewrote the employee manual and replaced the passive “Return-to-Work” policy with an active “Recovery-at-Work” plan. They also educated the local medical providers on the specific nature of the fabricator’s work, ensuring legitimate diagnoses moving forward.
The Result: One major claim was managed so effectively that it remained “medical only” (no lost time). This saved $40,000 directly and shaved an estimated 0.40 points off the Mod.