ADVANTAGE 1: Workers’ Compensation Claims Management
In a “loss sensitive” workers’ compensation program, management of both the frequency and severity of claims is essential. Every dollar that is not spent on settlement of a claim allows more premium dollars to move to the bottom line. Therefore, services that can help manage open claims to bring them to a timely and cost-effective resolution (reducing severity) become critical.
Benefits: Following are examples of the consulting services offered through the IMCG Concierge Claims Management:
• Claims Consultation
Experience has proven that having an independent claims consultant work with employers in claim analysis and resolution brings accountability to the insurance carrier adjusters and reduces the cost of claims, saving both time and money. A Concierge Claims Management (CCM) Claim Consultant is available for consultation on serious injuries that occur and offer advice on direction of medical care and development of an injury plan for the employee, recommendations for claim handling procedures, and specific claim reviews.
• Claim Management
The CCM Claim Consultant follows up as your advocate on each open indemnity claim with the insurance carrier claim adjuster. Specific services include:
• Review and analysis of insurance adjuster’s notes and conference with employer.
• Return-to-work program design and coordination.
• Attendance with employer at hearings, depositions and mediations.
• Written reports of all open claims with appropriate recommendations.
• Periodic on-site review meetings.
• Unit Stat Date Management
The unit stat date is identified, and open reserves are managed to this date for each client. Closing or reducing claims prior to this date will be a priority to maximize the impact on the calculation of the experience mod factor by the NCCI.
ADVANTAGE 2: Loss Control Consultation
Few employers can afford to hire a trained safety director, and yet an active and effective loss control program is essential to controlling the direct and indirect cost of claims. Statistics show that 92% of workplace injuries result not from environmental issues but rather attitudes and behaviors of employees.
Benefits: Concierge Claims Management can facilitate customized loss control solutions in the following areas:
• Benchmarking (historical claim analysis with peer review, study of cost of claims, trending)
• Written Safety Program (can help qualify your company for the 2% Safety Program Credit on your workers’ compensation policy)
• Job Safety Analysis (job site safety and OSHA compliance inspections)
• OSHA Compliance (review facility and records for OSHA compliance)
• Training Programs (training programs for supervisors and hourly employees)
• Accident Investigation (documentation of relevant accident site issues)
The end in mind is to be intentional and strategic in the reduction of frequency and severity of claims with a “best in class” focus for your industry, enhancing your appeal within the insurance marketplace.
ADVANTAGE 3: Mod Control and Solutions – Delivered
The workers’ compensation experience modification factor is an often overlooked or misunderstood element of a workers’ comp policy. While most employers realize that a lower mod factor is a good thing, many don’t recognize the opportunity for control they have over this number and the resulting impact on their net cost of workers’ compensation insurance. Statistics reveal that experience mod factors are often calculated incorrectly (up to 47% of the time) and of those, a majority of the errors resulted in a mod factor that was too high. Proper planning and partnership will bring insight and assistance in the management of this important cost driver.
Accuracy of data submitted for the calculation of the mod, managing the frequency and severity of claims, awareness of rating rules, and long-range planning are all essential elements in the management of the experience mod factor. Concierge Claims Management has the expertise and experience to work for your benefit in these areas and provide accountability through our Mod Auditing Program.
Benefits: Concierge Claims Management gives clients the ability to:
• Analyze and verify the accuracy of EMF calculations by the NCCI and reduce (as necessary)
• Ability to accurately project the experience rating factor before release by the NCCI
• Identify the minimum mod possible and calculate the controllable mod, thus illustrating potential premium savings
• Analyze losses to show what specific losses cost in increased premiums, including frequency and severity ratio and trends
• Better communicate the factors affecting the mod and direct primary loss prevention services to where it is most needed
• Increase accuracy of cost allocations and solidifying budget projections
ADVANTAGE 4: Annual Aggravated Inequity Assessment
The “Aggravated Inequity” Rule comes into play when an open claim in your experience period is closed after the unit stat report has already been submitted to the NCCI for your experience mod calculation, but still prior to the beginning of the next policy year. If within this window of time the claim closes at least 25% below the reserved amount, you are entitled to have your experience mod recalculated under the “aggravated inequity” rule.
The responsibility for identifying this condition is neither with the insurance carrier nor the NCCI, but the employer. But few employers or their agents are even aware of this rule and as a result, are potentially paying thousands of dollars in additional premiums due to an incorrect experience mod factor. Your CCM consultant annually monitors the claims data submitted to the NCCI to determine if such a condition exists and works with the insurance carrier and NCCI to have the mod corrected when an aggravated inequity is identified.
ADVANTAGE 5: Claim Coding Review
Errors in how a claim is classified (there are nine categories) can negatively impact an experience rating factor. Some carriers have claim coding procedures that may erroneously classify a claim into a higher-rated category. These must be monitored and corrected with the carrier before the data is submitted to the NCCI for the experience mod factor calculation. Concierge Claims Management reviews client loss runs on a monthly basis to ensure accurate coding of claims.
ADVANTAGE 6: Return-to-Work Coordination
Returning injured employees to work is critical in the management of the net cost of your workers’ compensation insurance. The employer has a seven-day window to return an employee to work and keep a claim classified as “Medical Only” which is discounted 70% over claims that involve indemnity payments. Concierge Claims Management can provide innovative assistance and consultation in returning injured employees back to light duty work to reduce or eliminate the impact of indemnity payments in a claim.
ADVANTAGE 7: Plan Evaluation and Design
Insurance Management Consultancy Group is one of the premier insurance brokerage and risk services providers in the state of Florida. We know workers’ compensation and we can effectively evaluate and design the appropriate program based on your experience and risk tolerance. Your current workers’ compensation cost is a reflection of the efforts you and your insurance agent have devoted to the program over the past four years. Where you will be in the future is dependent on the plan that is designed and implemented today. Insurance Management Consultancy Group can help you control and manage the net cost of your workers’ compensation program.
ADVANTAGE 8: Human Capital Expertise and Tools
Statistics tell us that 74% of workers’ compensation claims occur within the first 90 days of employment. This tells us that effective hiring practices, proper onboarding and HR management are critical components in controlling your net cost of workers’ compensation. IMCG can help.
As a client of Insurance Management Consultancy Group, you will have access to a powerful online HR research portal.
Features of the HR Toolkit include:
• Practical content on HR compliance and policy topics
• HR model documents (sample policies, notices, forms, job descriptions, interview questionnaires and more)
• Simplified law summaries
• Detailed discussions with expert analysis
• News and trends with weekly updates
In addition, Insurance Management Consultancy Group can offer substance abuse testing (for pre-employment screening, DOT and random) and background screening solutions to our clients at a preferred rate.
ADVANTAGE 9: Custom or “Off the Shelf”
Results do matter. Strategic and creative solutions are essential toward maintaining long-term success and preserving operating margins. We get this, and moreover, we understand the significance of delivering best-in-class solutions for our partners. It’s just that simple.
ADVANTAGE 10: Partnerships Matter
We are serious about our partnership approach with our clients in the management of their total cost of risk. Partnering with an organization that truly understands the challenges you face with the ability to bring both short- and long-term solutions is essential. Our Insurance Management Consultancy Group Learning Series: Excelleration™ is just one of the tangible expressions of that commitment. Every Insurance Management Consultancy Group colleague understands that a strong partnership is built upon a solid foundation of integrity and professional responsiveness through personal relationships benefiting all stakeholders.