The objective of our Claims Management program is to ensure prompt and appropriate medical treatment for employees who suffer work related injuries and to minimize the cost of claims. Our approach in addressing this challenge would be as follows:
- Review processes for employer’s first report (including injury assessments, employee statements, documentation, and follow-up)
- Establish preferred medical providers for initial injury evaluation and treatment
- Institute process for effective communication between all parties (client, medical provider, case manager, claims examiner, and injured employee)
- Identify potentially false or exaggerated claims and claims most likely to involve excessive lost time
- Implement return to work strategies, when appropriate, for lost time claims
- Identify litigated and controverted claims for special handling, assist in preparation for DIA proceedings, and attend proceedings when appropriate
- Periodic review of open claims with client
- Periodic review of complex, high-exposure claims with client and carrier’s claims examiners