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Work Comp Adjuster Contact Can Affect Reserves Heavily

Did you contact your Work Comp Adjuster this week or month?  Why did you not?

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If you have found something questionable about your total incurred or reserves, then you may want to contact your Work Comp adjuster.   Politeness and establishing a working relationship go very far with knowing your status for each claim. 

From being an adjuster many years ago and listening to adjusters’ comments, there are a few simple rules that will help you in discussing reserves/total incurred when contacting your adjuster:

  1. Know who your Workers Comp adjuster is for every one of your claims, even if you have a new carrier. If you do not know who this is – you need to find out.
  2. Email your adjuster – calling your adjuster is OK, but they will still have to look at what you are questioning and get back to you. Do not expect immediate answers.
  3. Do not say, “My reserves are too high” without specifics. We see agents do this one very often. Make sure you are updated with all the info.
  4. Be very specific with your questions. Do not send the adjuster a three-page email.
  5. Quite often, the adjuster does not know of a claim’s development that would make the file worth less $. Updating the adjuster by email on what is happening on the claim is a great idea. It is even better to scan and email or fax any info that you receive on the claim to the adjuster ASAP.
  6. Never threaten the adjuster with the Insurance Commissioner. This is only a last resort. Please remember you may have to work with this person on your claims for many years.
  7. Do not immediately ask for the adjuster’s supervisor. Give them time to resolve your concerns.

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  8. KNOW WHEN YOUR TOTAL INCURRED AND RESERVES hit your E-Mod. Calling an adjuster two weeks before your policy expiration is fruitless. See my old posts or email me at [email protected] on when your E-Mod is affected.
  9. Self-insureds – the adjuster is spending your $ directly from your budget. Even though there are no E-Mods to be concerned with, your Workers Comp LDFs are calculated from the reserves for budgeting purposes. We sometimes hear self-insureds say that they are glad they are not in the insurance system. You are even more than the non-self-insureds.
  10. If you feel that you would be in over your head, contact a claims professional – shameless plug – that is what we do every day.

 

Workers Comp is full of buzzwords. Please click on https://cutcompcosts.com/ and click on the Definitions tab for a large list of definitions or email us at [email protected] if you have questions on any of the terms used in this or prior posts.

Next Up – The Easiest Way to Monitor Your Claims and Lower Your Premiums

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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