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One Thing Not To Do With File Reserves on Loss Runs

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One Thing Not To Do On Your File Reserves

Working in a Claims Dept for many years, I had seen one thing that would totally backfire on an employer that had questions on their Workers Comp file reserves. If you have established a working relationship with your Workers Comp claims adjuster, the following may not apply.

Stack File Reserves in repository
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The one thing to not do centers around not being prepared. Calling your Workers Comp claims adjuster without being prepared to discuss the reserving on the file will usually cost your company more in premiums. Please remember that the Workers Comp adjuster is very similar to calling your bank’s loan officer. The issue of credibility is critical. Being prepared = credibility.

The easiest way to prepare is by reviewing the Workers Comp loss runs. Usually, the loss runs do not have a status. You can email your adjuster and ask for a status on every claim or obtain online access to your claims. You should be able to see what is happening with your claims online.

How do you know what Workers Comp reserves are correct? That is a very tough call. It takes most insurance adjusters 5 – 7 years to gain enough experience to set the reserves on files. Setting reserves is a tough business. If you do not feel comfortable having this discussion, please call a Workers Comp audit expert. As I said before, negotiating your Workers Comp reserves is like talking with your bank. It will directly affect your budget.

Finally, the one thing to not do is to just call up the adjuster and confront him/her that your reserves are too high.

Picture Business Meeting One Thing File Reserves
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This person is responsible for the reserves on your Workers Comp files which feed into your E-Mod that directly affects your insurance budget. This tactic can sometimes backfire.

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt 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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