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North Carolina Industrial Commission Invalidates Basic Adjusting

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North Carolina Industrial Commission Returns Form 24’s To Adjusters

Is The North Carolina Industrial Commission taking the first step in making policy determination a legal matter in the Tarheel State?

Folder with North Carolina Industrial Commission Documents
Wikimedia Commons – Tony Webster

Recently, I came across a few articles on how filing a Form 24 seems to be similar to practicing law.   The North Carolina Industrial Commission has decided , without a chance for industry or public involvement, to equate filing an Industrial Commission form with bringing suit against the employee.

An adjuster in one of the articles went through the process of how an adjuster would have to hire an attorney then immediately remove the attorney from the file after the Form 24 hearing.    The Form 24 is basically the adjuster requesting that an employee be removed from benefits, no more, no less.

If any of my readers were around in the adjusting world in the 1990’s, there was a decision by the North Carolina Supreme Court that opened all closed medical only claims for lifetime benefits.   The big carriers started pulling out of the state rather quickly as one of the assumptions of the Experience Modification system is that these claims once closed usually stayed closed after a two year window.

Why I am bringing this point up is that the Experience Modification system in North Carolina – as in the 1990’s – did not take into account the litigious environment that will now exist in the state.   I am not saying this is a bad turn of events to have to use defense attorney much more, but rather an unexpected one.   Will this cost employers a large amount of funds?

Hand Drawing Upward Arrows North Carolina Industrial Commission With Dollar Sign
StockUnlimited

One would have to say partially no, as this part of the Experience Modification system – better known as Allocated Expenses – ALAE – are not usually counted in promulgating an E-Mod.  However, there are many more expense such as extending the Temporary Total Disability period and increased medical costs that would cost employers more in the long run.

Raleigh is our HQ so this hits very close to home.   The North Carolina Industrial Commission has always been great concerning fixing these situations on an amicable basis with the help of the North Carolina Legislature.

Then again, I may be concerned about something that will never come to a full fruition.  However, I wanted to point it out.

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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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