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Bulk Workers’ Comp Claim Settlements Are Nothing New

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How To Set Up Your Own Bulk Workers’  Comp Claim Settlements

One of the major retailers published a news release concerning bulk Workers’ Comp claim settlements.

bulk workers' comp claim settlements groceries aisle pic
Public Domain – Daniel Case

The company had found out that many settlements had one or two sticking points that could easily settle by settling some of the “small things” involved with settlements.   The self-insured retailer called the method bulk Workers’  Comp claim settlements,

Bulk Workers’ Comp settlements started for me in the mid-1980s.   My supervisor was out for the day when I was a claims trainee.   I did not necessarily get along with my claims manager.

My bi-weekly claims review was due with my supervisor.  My claims manager decided to do the claims review with me (gulp!).

At the time, I was an all lines outside adjuster with a heavy claims load for a trainee.  My claims manager decided to cover only Workers’ Comp Claims as I had so many in my claims load.  (Double gulp!!)

One attorney’s name kept popping up in a certain region of my territory in Oklahoma.  Let us call him Attorney Tony.

My claims manager was surprised that the claims supervisor did not share a claims settlement technique that he and my absent supervisor had used very successfully.

My claims manager told me to print every summary sheet with Attorney Tony.  Call him up and go to the city where he practices with all of my claims summary sheets as long as the injured worker were not still drawing benefits.

In the 1980s in Oklahoma, Workers’ Comp settlements with represented clients were settled by Joint Petition.  If the injured workers’ attorney agreed to the settlement, the Oklahoma Workers’ Comp Commission Courts would approve it.

My claims manager also informed me not to buy the claimaint attorney’s lunch and do not let him buy mine – separate checks to avoid any appearance of a conflict of interest.

Attorney Tony was bilingual and had a large number of Spanish- speaking clients in this particular mid-sized Oklahoma town.   I pulled 18 files where his client was finished drawing weekly (Temporary Total or Temporary Partial) disability benefits.

I circled back to my claims manager that day and said – wait, I do not have Independent Medical Exams (IME”s) for ratings for all the 18 injured workers.  My claims manager said to go to the meetings, raised my settlement authority, and I was to call him, not my supervisor, if I went over my new temporary authority amount.   (Triple Gulp!!!)

Steak Frites bulk workers' comp claim settlements restaurant
Wikimedia Commons – LWY

I called Attorney Tony, and he agreed to meet me at a restaurant with large tables.  I think it was a steak restaurant.

We met in person the next week with my 18 claims summaries.  I thought – how will I settle these without IME’s.  My bulk workers’ comp settlements had begun in earnest.

Attorney Tony came with no notes.  He knew all of the files by heart – impressive.  He shook my hand and said – “Look, we can spend months with me sending my clients to his usual IME physicians and I could do the same, or we can settle all 18 files today. – What?

Oklahoma allowed PPD Rating stipulations at that time.  I liked the security of an IME to back me up, so I was very hesitant.

We went through the files one by one.  Attorney Tony said Ok, so for Mrs. Jones, I can get an IME of 15% to the body (45 weeks of benefits), and you can probably get a )0% (no weeks of benefit)s.  Quite a few of these were non-surgical so Attorney Tony said he would stipulate that I had 0% ratings on all of them and then we discussed what rating that I would stipulate to settle and close the file by averaging the ratings.

We covered 14 files in this manner.  That left four files with posts-surgical  PPD considerations.  The four had ratings from the treating Doctor.

I had to stipulate to higher ratings, and he stipulated to the treating physician ratings or something along those lines.   We hashed those out over the rest of the two-hour lunch.

Wow, 18 files settled by using a bulk workers’ comp settlement technique first given to me by my claims manager.

Still yet today, I think that my claims manager had given Attorney a heads-up call that a claims trainee had a stack of files to settle and not to take advantage of my newness.

Eighteen files covered almost 15% of my Workers’ Comp claim file load.

When I returned to the office the next day, my claims manager called me into his office and asked me how it went with Attorney Tony.   I informed him all 18 files settled with only four having to be hashed out more heavily.

My claims manager said that we save three to four months and 36 IMEs on those 18 files.

Petition of bulk workers' comp claim settlements right
Wikimedia Commons – Parliament of England

I could not even remember what I had for lunch; I was so nervous.  My claims assistant had to type up 18 Joint Petitions.  They were not happy as they did take some time to produce for the Court.    The carrier had to type them up, not the claimant attorney.

After that interesting lunch, Attorney Tony and I would settle files over the phone using the same workers’ comp claims bulk settlement technique.

My  Quick Guide on Bulk Claim Settlements

  • Follow the rules of your state -you may not be in a state that allows bulk settlements or stipulations.
  • Find the claimant attorney with the most files in your claims load
  • Make some appointment with the attorney, even go to their office or meet for lunch at least for the first time
  • Make sure your usual defense counsel has no reservations about settling the files using this method. They should not if it is legal and proper.
  • Know your claims cold that you wish to discuss. if you are hesitant, you lose
  • Very important — make sure you have the authority to settle. Make sure your claims department is OK with settling claims this way.
  • Do not debate with the attorney
  • If you want to bring along an attorney, that would be OK, but that could change the dynamics.
  • Bulk settlements may not work with certain claimant attorneys. Do not even try it.
  • Buy your own lunch or coffee. Make sure the place has room for any documents you may wish to spread out on the table.  A corner booth works well.
  • If you feel like you are in over your head, call it a lunch or meeting and go back to your office. Do not be intimidated.
  • After meeting in person, you will be surprised at how many files settle quickly over the phone.

 

I wish you good luck with your workers’ comp bulk claim settlements.  Now go settle some claims.

 

©J&L Risk Management Inc Copyright Notice

 

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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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