Loss Run Online Access Is Just The Beginning
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 usually cannot 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 loss-run reviews must be 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.
Most insurance carriers or Third Party Administrator computer systems will automatically send you a notice by email when a reserve reaches a certain level. However, the level has to be set for your company at the beginning of the policy or agreement.
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.
Up Next – What to Look For in a Work Comp Claims Review Expert
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