Workers Comp Claim Loss Runs – Only Part of the Story
I had quite a few discussions over the last few weeks on Workers Comp claim loss runs. My conclusion was that U needed to cover why relying solely on them to make a current risk assessment leaves out quite a large amount of info.
Most loss runs do contain basic info, some more than others. Each insurance carrier or TPA (self-insureds) structures its loss runs in very different ways. I would include an example page from a workers comp claims loss run, but due to them being so differently structured, the easiest way is to cover the terms.
Who Uses Workers Comp Claims Loss Runs?
Many more people than one might think use loss runs.
Insurance personnel include:
- Actuaries
- Underwriters
- Loss Prevention
- Agents
- Claim Adjusters
- Premium Auditors
Some just have basic claim values such as:
- Indemnity Paid, Medical Paid, Expenses Paid
- Indemnity Reserves, Medical Reserves, Expense Reserves – The ones to negotiate
- Indemnity Total Incurred, Medical Total Incurred, Expenses Total Incurred
Of course, Paid + Reserves = Total Incurred
One recommendation is to include a two- or more-line claims status.
Best Way to Keep Up with Your Claims
I have recommended online claims access for decades. Check the prior link to see how $85,000 was recovered by starting with claims access.
I do understand that not all carriers and TPAs allow full claims access. HIPAA concerns have been in place for decades. Requesting limited claims access may be the best way, or having a working relationship with your claim adjusters.
Most Workers Comp claims adjusters that I know, or have a working relationship with, will usually reciprocate your interest. Many times, the loss run will contain the adjuster’s name. Do not forget about the often overlooked medical-only claims.
Set up how you want to receive your workers comp claim loss runs when you sign up for your policy, or a TPA agreement for self-insureds.
The bottom line is to pay attention to your claims at least monthly. Participating in the claims process will reap benefits for your company’s bottom line and for your injured employees.
