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Not Reporting Claims To The Carrier – You Can Pay It Now Or Pay 400% More Later

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Not Reporting Claims Can Be Very Expensive

One way to pay more for WC claims is not Reporting Claims to your insurance carrier.  The second part of the title is from the Fram Filter commercials. I had come up with four areas, which I have posted to blogs and our website often, on the Four (Now Five) Keys To Cutting Your Workers Compensation Costs.

Clipart of Reporting Claims form
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When an employer delays or avoids reporting their First Reports of Injury (FROI), that employer will pay an extra 400% on their Workers Comp premiums. I performed two massive data studies using anonymous public Workers Comp data 10 years ago and then again two years ago. One of the hallmarks is that medical only and small lost time claims festering (a term I coined) costs employers big $$$.

If claims go unreported or delayed:
• Proper investigation by insurance staff cannot be completed
• Medical control is compromised
• Access to medical and other documents can be hampered
• Medical bills not process for fee schedule and PPO reductions
• Injured workers’ questions not answered, feel like they are in limbo
• Higher amount of attorney involvement
Fines and penalties possible
• Time limit on certain defenses tolled

Female Doctor Writing Reporting Claims On Desk Clinic
StockUnlimited

I could go on with the list, however I think you see my point. J&L is dedicated to saving employers Workers Comp premium by using time-tested techniques. Not involving your carrier or TPA is not a Risk Management cost savings technique. It may work well in the short term, but not in the long term.

One of my PowerPoint slides says All Claims Are Set in Stone after 48 hours. I will cover that point next time. If you wish to receive our newsletter, which is a summary of the blog, sign up for our weekly email. The signup box is down the right side of the page.

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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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