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Workers Comp Claims Adjuster – Defending Tough Job


Workers Comp Claims Adjuster Can Be A Tough Job

The Workers Comp Claims Adjuster possesses a job that can be nerve wracking.  One of our services is to review files to see how the claims adjusting staff performed on a group of claims. I had recently read a LinkedIn post slamming Workers Comp claims adjusters. The poster had recommended to the other readers to challenge an adjuster by asking them to on-the-spot give an immediate answer on a claim. I see this in posts and artifices approximately twice per year.

Graphic Of Gavel Workers Comp Claims Adjuster Defense

Asking an adjuster to discuss one file on-the-spot is the same as asking someone what they had for lunch over a month ago. We recommend that an employer establish a working relationship with their adjusters. Expecting an adjuster to not pull the file and review it before giving an answer or status is going to leave an employer disappointed.

We always recommend emailing adjusters and expecting an answer to the email within 24 business hours. This allows the Workers Compensation adjuster time to review the part of the file to give an acceptable answer. An email is very strong written documentation for the employer and the adjuster.

I wrote about this situation in a manual that I wrote on controlling Workers Comp costs.

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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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