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Claim Reviews = ‘Tis Season For Wasting Time Fa La La La


Tis’ The Season For Claim Reviews

Many articles have appeared in this blog on claim reviews.

One of the best methods to keep abreast of your current Workers Compensation claims situation is by reviewing your claims with your insurance carrier.

Graphic Of Claim Reviews Tis' Season Letering
Stock Unlimited

We have seen many times where reviews are scheduled for the last two weeks of December as the policy renewal is on January 1st.  While it is always great to do a claim review, the value of your claims in December has very little to do with your upcoming E-mod calculation, better known as promulgation.

We have been called in to assist with December 31 reviews quite a few times.  Unless the policy renews July 1st or later, we usually suggest a reschedule of that meeting as the Workers Comp policies that renew in July or later would be the applicable policies for a December claims review.

Your review should have been in May or June, earlier in the year, as your E-Mod actually pegged at 12 midnight on July 1st.   The Workers Comp system is a 6-month delayed system to allow your insurance carrier a longer period for claims development.

There are many schedules for reviews on this blog.   Use the search box to find them.

I am not discouraging claim reviews as any review at any time is great.   However, the timing of these critical reviews will avoid wasting time when your company (and your insurance carrier) have so much on their plate.

This does not apply to self-insureds as your company or organization should have a Loss Development Factor that is usually tabulated on a very different schedule.

Happy Holidays and remember  3 months after your current policy renews or 6 months before your TPA contract expires is the best time for claim reviews.

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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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