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Workers Comp Claims Adjusting Services – Getting The Best Deal


WC Claims Adjusting Services

The Claims adjusting services can be found with an RFP  for Workers Comp services. This is one of the “touchiest” subjects in Workers Comp right now with employers and governmental agencies. Risk Managers, company owners, CFO’s, and anyone in charge of their company’s Workers Compensation program are becoming very aware they may be spending too much in this area.

Picture Of Business People Adjusting Services Shaking Hands

Quite often, a carrier or Third Party Administrator (TPA) will offer a package inside of their claims adjusting bid that may not be the most beneficial to their client. This may not be done on purpose. It is just the result of the very complicated services structure such as medical bill processing that exists in Workers Comp and disability claims environment.

One recent comment from a Risk Manager/CFO was that examining RFP’s for Workers Comp claims handling and all the other services was akin to “shopping for a car with all the different options.”I can understand that point. In looking over RFP’s from across the nation, there seems to be more attention to this point.

Many governmental agencies’ RFP’s now ask for only the claims processing fees, not the medical bill processing or the rehabilitation nurse fees to be calculated into the bid. In fact, quite a few have their own established “ala carte” services they have purchased to more effectively breakdown the costs.

Picture Of Ala Carte Adjusting Services Black And White
Wikipedia – White Star Line

A very large city school system has purchased each part of the Workers Comp claims adjusting services separately by purchasing each service from a different vendor. That may be taking the “ala carte” idea a little far.

I am presently reading an RFP from Indiana where the governmental agency specifically required a bid for claims adjusting and processing only.If any other services were mentioned, the bid would automatically be removed from consideration.

Are we getting to the point where the person(s) responsible for choosing the Workers Compensation claims adjusting vendors are going to have to do multiple RFP’s? If so, there would need to be at least five different ones.

I will be covering Workers Comp medical bill processing in my next post. It may be a shocker to some – which is a good thing.

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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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