You have online access or you have all of the loss runs – what do you do now?
You will mainly be concerned with just the reserving part of the claim for now. One of the important points to remember is that with a Workers Comp loss run review, you cannot really question what has happened in the past, especially on closed claims. The Total Incurred for a closed claim is the amount paid. There is not much you can do once a bill or settlement has been paid. That is why it is important that Loss Run Reviews are performed quarterly or monthly.
Do you have an email sent to you if reserves reach a certain level or if a massive bill/settlement is being considered? If not, you are leaving an open checkbook against your E-Mod.
Without a claims technical background, common sense is the rule for doing loss run reviews. Take a look at the open claims.
- Does the amount for reserves (Total Incurred minus Paid) look right?
- Has the claim that was once a more serious claim now resolved itself?
- Is the employee back to work?
- Do you have an employee on your loss run that is not one of your employees?
- The list goes on and on for areas to possibly find mistakes in a Workers Comp claims reserve/loss run review.
If you feel that there is still something wrong after doing a self-review, you may want to contact a Workers Comp claims review expert.
Shameless plug – Claims reviews and especially online claims reviews are our specialty along with premium audits.
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Article provided by James J Moore, AIC, MBA, ChFC, ARM. All articles are original content. Check out the full website at www.cutcompcosts.com.