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Your Reserve Review Action Plan – Have You Contacted Adjuster

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Reserve Review Action Plan

I had posted often over the last few weeks concerning claimx`s review for insureds with a January 1, 2011 renewal date. I even included a schedule of sorts on how to proceed on a Workers Comp reserve review. I used the 1/1/2011 policy renewal date as an example. One of the main things to remember is that you are looking to lower your E-Mod for next year. For a 1/1/2011 policy renewal date your E-Mod is calculated at the close of business of 6/30/11 for your 2012 policy.

Vector of Hands Reserve Review in Calendar Big Pencil Noted
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If your policy does not renew on January 1, then add the difference onto the dates I have given you in this and past posts. For instance, if you have a policy renewal date of 4/1/11, then just add three months onto the dates I have given you in the earlier posts. If you have a January 1st renewal date and you have not started your reserve review, then you are definitely behind schedule.

If you are on schedule, the next step is contacting the claims department and in particular your Workers Compensation adjuster to review the claims in which you had reserve questions. As I said in my last post on this subject, knowing which claims to review and which ones to leave alone can be critical. Sometimes, a full formal review of your reserves with an adjuster may result in an increase to your reserves and E-Mod.

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One of the unwritten ground rules is to not call the adjuster and say lower my reserves, they are just too high. The best method of contact is by email for documentation and it will allow the adjuster to look everything over and get back with you.

If you have any questions on this info, please feel free to call me at (800) 813-1386 or email me at [email protected]

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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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