Workers Comp Claims Adjusting ASAP – It’s Over in 48 Hours

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Workers Comp Claims Adjusting – Do It Now on New Claims

The Workers Comp claims adjusting for new claims is over in 48 hours.  I know – sounds like a bold statement.  The old paradigm used to be 24 hours.   I am giving the adjusters a break.

Many of my webinars and presentations on handling claims by employers and the claims staff always come with a warning.   As Roy Orbison sang – It’s over.

roy orbison pic workers comp claims adjusting over 48
Wiki Public Use – Ronzoni

Check out this article on the 48-hour timeclock.   Most of the links in this article were written at least 12 years ago.

New Claim Over in 48 Hours – A Timeline

My Six Keys to Saving on Workers Comp follows the same timeline.   The steps are:

  1. The employee has an accident.  For employers – are injury reporting procedures in place?  If not, an expensive delay has already occurred – the adjuster has not seen the claim yet.
  2. The employee reports the accident.  Does the employer have procedures for reporting an accident?
  3. The claim is filed.  The injured employee seeks out medical treatment.   The workers comp claims adjusting process has not started yet.  Medical control of the file has already been established by the employer and employee.
  4. The adjuster receives the claim.  They contact the employer, treating physician, and injured employee – if the claims staff performs the critical three-point contact. 
  5. In #4, the first report of injury may be on the adjuster’s screen after the 48-hour time frame.   That is why ASAP remains the best way to obtain and keep control of the claim throughout the process.

The injured employee has reported the claim, sought medical treatment, and may be off work by the time the first report of injury is received by the claims adjuster.

Workers Comp Claims Adjusting vs. First Impressions

Man treating Workers Comp Claims Adjusting an injured person's leg
Wikimedia commons – Public domain

The employee has already interacted with their employer in reporting the claim.  The claims clock ticks away.

The important part  – the injured employee has already judged the workers’ comp process first-hand.  They have already developed a positive or negative attitude by going through the process.

The claim is 48 hours old.   Every part of the workers comp claims adjusting process will not really change the claim.  First impressions count.

Over the years, I realized why my first claims manager would go ballistic if the three-point contact was not made within 24 hours even if the claim came in on a Friday afternoon.

One saving grace comes from the WCRI (Workers Comp Research Institute) with the studies by Dr. Savych.  The one component when looking back on their claim after the resolution was the trust of the employer by the employee.

 

 

 

©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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