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Search Results for: subrogation

Subrogation Services Finds Money Left On The Table In Claims

Our subrogation services helps recover money left on the table.  Subrogation remains one of the areas that confounds many Workers’ Compensation insurance adjusters.   A few decades ago, insurance adjusters covered many lines of insurance, including crop and life.  The insurance industry split the lines of insurance adjusting. Workers’ Comp became

Workers Comp Subrogation Claim – Very Old Reserves Still Open

Very Old Workers Comp Subrogation Claim – Loss Run Says Open – Why? A new blog and newsletter reader asked this question last week after reviewing their Loss Runs – we have a very old workers comp subrogation claim open after seven years – will that affect our Experience Mod

Workers Comp Liability Subrogation – Vehicle Accident Steps

Workers Comp Liability Subrogation – Seven Steps For Vehicles What Is Workers Comp Liability Subrogation for auto accidents?  Let us take an example I have on my screen in front of me. The insured employers and adjusters working on this together allow for quicker recoveries from any third party in

Workers Compensation Online Access Nets Insured $85,000 Subrogation

Workers Compensation Online Access – Subrogation Claim Discovered Having Workers’ Compensation online access creates $85,000 subrogation claims missed earlier by the insured.  How did this occur? I review claims for many companies as part of J&L’s services.   Recently, a new agency account asked me to review their claims and make

Waiver of Subrogation Endorsement – Excellent Analysis Chart

Misunderstood Waiver of Subrogation Endorsement – Why You Should Read Your Workers Comp Policy The Waiver of Subrogation Endorsement appears in almost all workers’ comp policies.   Almost all workers’ comp personnel and insureds do not ever read any policies.  Who wants to read 40 pages of droning on when the

Subrogation Letter Is Just First Step in Recovering Workers Comp Funds

The Subrogation Letter Should Not Be Solely Relied Upon To Recover Workers Comp Payouts A quick subrogation letter remains one of the stalwarts in recovering workers compensation funds back to a file whenever there is a responsible 3rd party involved in a Workers Comp accident. The best example is an

North Carolina Work Comp Subrogation Takes Weird Turn

North Carolina Work Comp Subrogation Re-re-reverses Course The subject of North Carolina Work Comp subrogation has frustrated carrier and Third Party Administrator claims staffs over the years.   This case could be a model for changing subrogation laws in other states – possibly. One of my concerns is that Workers Comp

Workers Comp Reserve Reviews And Subrogation – Three Concerns

Workers Comp Reserve Reviews And Subrogation Our Workers Comp Reserve reviews uncover many concerns on claims handling.  Subrogation refers to an insurance company seeking reimbursement from the person or entity legally responsible for an accident after the insurer has paid out money on behalf of its insured. In Workers Compensation,

NCCI Report On Auto Accidents Has Interesting Subrogation Numbers

Auto Accidents Report Has Interesting Side Statistics The NCCI report on Auto accidents. NCCI (National Council on Compensation Insurance) is the largest rating bureau in the nation.  Their statistics cover 21 or more states.   One of most dangerous places to work is in your automobile according to their report.

Transfer Of Right Of Recovery Usually Means Waiver of Subrogation

Transfer Of Right Of Recovery = Waiver A transfer of right of recovery for Workers Comp usually involves a very specific type of waiver. The act of giving up the right by an insurer of collecting from another entity for payment on behalf of the insured. In current standard policies,

Waiver Of Subrogation – Very Popular Term in Workers Compensation

Term Of the Day – Waiver Of Subrogation The WC term of the day waiver of subrogation clause is very popular in insurance policies and rental agreements. This type of waiver is when one party gives up the right to pursue another third party for paid damages if the third

Subrogation – Where Did The Money Go – Can You Still Get It Back?

Where Did The Money Go – Subrogation Bleeds Work Comp Funds Where did the money go with your subrogation?  I have posted on this subject often such as in this article. Workers Comp subrogation seems to be one of those subjects that is passed over often. Self-insureds need to be

Does Workers Compensation Subrogation Exist- Is it Worth Pursuing?

 Workers Compensation Subrogation Can Be Money Left On The Table Does Workers Comp subrogation exist in Workers Comp claim department?  Subrogation is one of those under- the-radar terms in Workers Compensation.   It is the  act of recovering the amount paid for a loss by an insurer from the entity

Workers Comp Subrogation – Risk Management Diary Recommendation

Risk Management Diary For Workers Comp Subrogation The Workers Comp Subrogation  handlers should have a risk management diary.   A few posts ago I analyzed the Workers Compensation adjuster situation in handling third party liability claims. In defense of the Workers Comp adjuster, a requirement for the job is NOT

Subrogation – Workers Comp Money Left On Table

Workers Comp Money – Subrogation Concerns Sometimes Subrogation turns into the Workers Comp money left on the table. I have covered subrogation a few times in prior posts. I am bringing it up again due to our recent Workers Comp file reviews. One area that we have noticed a lack

Subrogation – Mystery Workers Comp Premium Refund

Subrogation – The Silent Workers Comp Premium Refund A Workers Comp premium refund that no one talks about is subrogation.  I have posted on subrogation in the past.  I would re-post the standard definition for subrogation, but it is one of the most confusing definitions in all of Workers Compensation.

Subrogation – Under The Radar in Workers Comp Claim Reviews

Subrogation Not On Radar Screens In Work Comp Files The topic of subrogation is one of the most misunderstood areas in insurance, and especially Workers Compensation, that we see costing insureds millions of dollars a year. Subrogation: Prevents the insured from collecting loss payments from his or her own insurer

Work Comp Subrogation – Third Concern When Ignored By Adjusting Staff

Work Comp Subrogation Additional Concern Work Comp subrogation has a kind of quirky standard definition. To me, it is the possibility of another party having to share the monetary responsibility of an insured incident or accident. I give the example in my manual of a company salesperson on sales calls

Why Do Loss Run Numbers Never Match Experience Mod Sheets?

Recent Reader Question  – Loss Run Numbers and Experience Mod Sheets Confusion One of the most frequent questions that we have received over the years is why the workers’ comp loss run numbers never match the info on the Experience Mod Sheets.   Let us look at three reasons why this

Per Diems – Vexing Part of Average Weekly Wage – One Easy Fix

The Vexing Part of Workers Comp -Average Weekly Wages – Per Diems – Easy Fix I was reading an article written by John Kamin, Attorney on his blog concerning per diems.  Even though the article and case were on California claims, two of the article’s conclusions rang very true –

Workers Comp Self Insurance Calendar – Important Dates To Remember

Workers Comp Self-Insurance Calendar – Repetitiveness is Key Last week, I wrote an article on the voluntary market policy calendars. I did not want to leave out self-insureds as I sometimes forget is 15% of the market needs to be considered more often in studies, articles, and even in my

Workers Comp Claims Departments Rarely Sourced For Studies

Workers Comp Claims Departments Have Often Ignored Numbers and Opinions Why are Workers Comp claims departments so rarely asked for input into studies for financial data or opinions?   Many articles have been written over the years on studies concerning Workers Comp data that obviously did not ask any claims staff

Paying Workers Comp Benefits Late – Five Ways It Can Cost You

Paying Workers Compensation Late – Five Ways It Costs Claims Staff Paying Workers Comp benefits late can cause a claims adjuster or staff many headaches that quickly can avoid many problems in the future.  Many states have rules on the books that penalize slow payers for benefits that are owed

2022 Workers Comp Self-Insured Resolutions – A Few Changes

2022 Workers Comp Self-Insured Resolutions – Post-Pandemic(?) The 2022 Workers Comp self-insured resolutions should be looked at as a bridge from the pandemic to the post-pandemic era. Over the last 13+ years including 2021, I have written articles on workers comp resolutions.  Our self-insured clients and article/newsletter readers always remind

2022 Workers Comp Resolutions – Major Updates to 2021 + COVID

2022 Workers Comp Resolutions – A Few Major Changes The 2022 Workers Comp resolutions have changed from the 2021 resolutions.  I have written resolutions for almost 15 years.  As with the whole Workers Comp industry, the resolutions have changed a little, but not substantially. Keeping to the below resolutions will

Workers Comp Benefits Quiz – Test Your Knowledge – Updated

Workers Comp Benefits Quiz – 10 Quick Questions – Answered Most of the answers to this workers comp benefits quiz are in the articles that I have written since 2007.  Good luck. The answers will be provided on Monday, August 23rd with an article update.  If there are any questions

J&L Risk Management Consultants – Your Workers Comp Problems Solved

Ready to cut your Worker’s Compensation costs? Discover and Correct Workers Compensation Premium Audit Errors and Mistakes. Contact Us Whether you call it Workman’s Compensation, Workmen’s Compensation, Workers’ Compensation, Work Comp, or Workers Comp, it is still the same, silent budget killer. Workers’ Compensation is one of the most complex

Claims Review

We recommend claims reviews every month using the loss runs.  Online access enhances any review.  The employer can review their claims without a formal claims meeting.   Online access allows an insured employer to review their claims whenever they wish to assess their claims.   One caveat from performing a

WCIRB Over-reserving Correction- California Update

WCIRB Over-reserving Correction – Rating Bureau Helps Out Employers – Wow! The Webinar Info Is at the bottom of this article California’s Workers’ Comp Insurance Rating Bureau provides a great assist to employers. The WCIRB over-reserving correction algorithm helps employers greatly.  Kudos to them – read on to see how

Experience Mod Increases While Loss Runs Show No Changes – WTR?

Upset Reader Says Experience Mod Increases – Loss Run Had No Changes   One noticeable complaint tread from our article and newsletter readers recently comes from Experience Mod increases while their company’s loss runs show no changes. Many of them have become clients to have J&L examine their loss runs compared

2021 Self Insured Workers Comp Resolutions – The COVID Effect

2021 Self Insured Workers Comp Resolutions COVID Caused A Few Changes Most New Year’s Resolutions come from altering the resolutions from last year.   The 2021 Self Insured Workers Comp resolutions will be no different.   Keeping the resolutions from last year and adding a few changes for COVID should suffice for

2021 Workers Comp Resolutions – Few COVID-19 Changes

2021 Workers Comp Resolutions – Huge Change From 2020? The 2021 Workers Comp resolutions began with waiting until all the election cycles had been completed from 2020.  I usually crank out the resolutions in December of the prior year.  With so much occurring in forgettable 2020, these resolutions were the

Self Insured Claims Data – Your TPA Has Many Helpful Options Online

Self Insured Claims Data – Going Beyond A Loss Run J&L examines loads of self insured claims data every month.  Some TPAs offer loads of information that go beyond just reviewing a loss run. Much of the self insured claims data can be reviewed using notifications as bells and whistles. 

Workers Comp Reserve Reduction Strategy – Critical Last Step

Workers Comp Reserve Reduction Strategy – Do This Last Critical Step Many articles in this blog center around formulating and enacting your workers comp reserve reduction strategy.   We have heard from many article/blog readers -where the anticipated reserve reductions did not tabulate properly. We heard from an agent today with

Workers Comp Recorded Statements – Now A Lost Art?

Whatever Happened to Workers Comp Recorded Statements? Not too long ago, workers comp recorded statements appeared in every file where the injured worker received any type of weekly comp benefits – a mailed check. Workers Comp Recorded Statement Requirements Some of the requirements were: a recorded statement of the injured

Workers Comp Mega Claims – My Different Definition

Workers Comp Mega Claims From A Claims Standpoint A meeting notice caused me to write this article on Workers Comp mega claims.  If you have not signed up for the webinar and you have anything to do with workers’ compensation, please go here and sign up.  Yes, I registered earlier

Workers Comp Ladder of Insurance Very Important Term in 2020

Workers Comp Ladder of Insurance – Subs of Subs Become Employees Early in my career, my insurance company employer sent me to what was a whirlwind of legal terms and concepts known as subrogation.   I took notes until my arm cramped with pain as I know this was important information. 

How To Ruin A Workers Comp Claim in Five Seconds, Claim Number?

Asking For Claim Numbers Can Wreck Any Workers Comp Relationship – J&L  Yesterday, I was trying to locate a claim for a long-term client.  I was following the subrogation status on a claim for them.   I was told that I had left out one number in a 22-character claim number. 

2020 Self Insured Workers’ Comp Resolutions – Staying the Course

2020 Self Insured Workers Comp Resolutions – Not Changing Success The 2020 Self Insured Workers Comp Resolution centers around sustaining success in your program and fixing a few issues that may be costing you dearly.   Some of these resolutions come from the old resolutions. Search self-insured resolutions for suggestions from

2020 Workers Comp Resolutions – Make Your List Now And Check It Twice

2020 Workers Comp Resolutions – Starting With A Clean Slate Your 2020 Workers Comp resolutions begin with the obvious – start the list now in late 2019.   I usually build off the previous years’ lists. Next week, I will publish a list for self-insureds.  This year let us start with

Workers Comp Claim Action Plan- Online Access Answers 100+ Questions

Workers Comp Claim Action Plan – Online Access Answers 90% of Questions Most Workers Comp Claim Action Plans cause the adjusters to have to do a ton of work.   Long ago, when I was a full-time adjuster, I looked forward to closing out a file so that I did not

$250,000 Claim Reserve Level – Why Is that Number So Important?

$250,000 Claim Reserve Level Creates Many Critical Responsibilities The $250,000 claim reserve level causes many necessary actions.  Some of them are obvious.   The other not-so-obvious actions are just as important. Please note that the Reinsurer and Excess Insurer are the same for this article. Usually,  a claim that reaches this

Workers Compensation Reserves – How Does Adjuster Set Them?

Workers Compensation Reserves – The Illusive Moving Target All Workers Compensation reserves have a common element.   Very few, if any, employers, actuaries, underwriters, agents, and any other players in this hybrid insurance understand how reserves are set – other than the adjusters themselves. By the way, that is a graphical

Certified Return Receipt Mail – Old School Workers Comp Life Saver

Certified Return Receipt Mail – Workers Comp CYA The use of Certified Return Receipt Mail may seem out-of-date in the age of Facebook, Twitter,  etc.   However, when the chips are down, having that little green card in your Worker Comp file is like a stroll on the beach – very

Associate In Claims (AIC) – Never Looked Better For Work Comp Adjusters

Associate In Claims (AIC) Designation Recommended For Work Comp Adjusters The Associate in Claims Designation (AIC) is highly recommended for quite a few old and new reasons.  One of the areas to consider is advances in technology. Technological Advancement The level of technology in claims adjusting will likely advance very

Top 10 Risk Management Techniques For Workers Comp

Top 10 Risk Management Techniques The Risk Management Techniques for Workers Comp can vary by state. One technique may not work in a certain state. The following is a list of great risk management techniques for Workers Comp.  The list is generic.  Most should work in every state.   These

Work Comp Predictive Models vs Gut Feelings – The Winner Is(?)

Work Comp Predictive Models There are so many articles on Work Comp predictive models out in the blogosphere.   Many taut their ability to see into the future.   I am not a big fan of predictive models as I have yet to see and am still waiting on one

Workers Comp Articles – Outside of US

Workers Comp Articles The 1,530+ workers comp articles on Cutcompcosts cover some of the topics outside the US.  I will try to cover more of those in the upcoming weeks. The last workers comp questions and answers were very popular.  Below are questions that pertain to WC outside of the

WALSH Jurisdiction Test – North Carolina Court Of Appeals

North Carolina Court of Appeals and the WALSH Jurisdiction Test The WALSH Jurisdiction Test for Workers Compensation has always seemed to work when multi-jurisdictions (states) are involved in a claim.  One of the most recent cases concerning the WALSH Jurisdictional test occurred in North Carolina at the appellate level. If

Exclusive Remedy Affirmed by North Carolina Appeals Court

Exclusive Remedy – North Carolina Affirms The North Carolina Court of Appeals has ruled the doctrine of exclusive remedy is still intact.  The legal environment of today has begun to erode exclusive remedy. Workers Compensation was originally structured to be the only remedy for injuries suffered on the job.  

Six Ways To Excel In Comp Arena Without A College Degree

Six Ways To Excel In the Comp Arena With No College Degree The Comp arena has more than six ways to excel without a college degree.   Below is a list of the Top Six, in my humble opinion. Is there a way to excel in the WC industry without a

NCPRIMA Presentation Work Comp Advice For Public Risk Managers

The Full NCPRIMA Presentation With Slides Included Last week, I presented at the NCPRIMA Annual Conference.  The slides for the full NCPRIMA presentation can be found here. We received a few requests for a transcript of the presentation.  The rest of this post follows the slides.  The presentation was aimed

Liability Adjusting Is Part of Workers Compensation Claims

Liability Adjusting Enables Great Workers Comp Adjusting One of the more complex liability adjusting components of  Workers Comp claims is subrogation. Subrogation rears its ugly head (or the lack thereof) on a large percentage of Workers Compensation files.  The percentage referred to is the lack of knowledge by WC adjusters

Work Comp Consultants

J&L”s Risk Management Workers Comp Consultants As Workers Comp Consultants, there are many areas of consulting in which we specialize for our clients.   Our premium reduction services center on specialized premium analysis.  Expert Witness Services Our founder has reviewed hundreds of files for employers, Third Party Administrators and carriers.

Manuals Are Now Free – Just Email or Call Us For Your Free Copy

Order Your Copy Start Saving on Workers Comp If you would like to order your copy please call (800) 813-1386 or email us at [email protected] Table Of Contents FOREWORD 3 JUMP-STARTING YOUR INSURANCE PROGRAM 3 OVERCHARGES 4 CLASSIFICATIONS 4 SUBCONTRACTORS 5 TEMPORARY EMPLOYEES 6 TEMPORARY EMPLOYEES 6 ALTERNATIVES TO TRADITIONAL INSURANCE PROGRAMS


These definitions are designed for use when dealing with any WC insurance personnel, especially when renewing your WC policies.  A – B – C – D – E – F – G – H – I – J – K – L – M – N – O – P – Q – R  – S – T –

Are Workers Comp Premiums Just Another Type of Tax?

Workers Comp Premiums – Type of Tax Yes, Workers Comp premiums could be thought of as a tax of sorts.   The similarities between taxes and Workers Compensation were spelled out in a previous article. Unemployment insurance (UI), which can be viewed as a tax, is even more similar.  

Workers Comp Loss Runs – Ten Quick Ways To Analyze

Ten Quick Ways – Review Workers Comp Loss Runs Your workers comp loss runs are a very important step in reducing your company’s premiums or insurance budget,  NCCI, WCIRB or any rating bureau uses the info that is provided to your company by your insurance carrier.  Actuaries will use the

Workers Comp Enforcement Increased By North Carolina Legislature

Workers Comp Enforcement Increase with HB 237 The Workers Comp enforcement was increased by the NC legislature this week. The North Carolina Legislature amended House Bill 237 – known as the 2011 Workers Comp reforms.  The amendments were in response to a very inquisitive reporter discovering 30,000 employers in North

Self Insurers Can Ruin Their Programs – 12 Hidden Ways

Self Insurers Can Ruin Their Programs Without Realizing It The first 12 ways self insurers ruin their Workers Comp programs are below.  Workers Compensation self insurance can be more complicated than paying for a regular policy. I have received many emails asking me to comment on how self insureds can

Workers Compensation Audits Five Types To Cut Comp Costs

Workers Compensation Audits – Five Types For Cost Savings We often receive questions centering on Workers Compensation audits.  Audits – we like to call them reviews are an essential method to cut comp costs. This term may cover many types of audits or reviews. I thought I would cover the

Self Insured Edition – 5 Ways Workers Compensation Programs Fail

Self Insured Edition – Workers Compensation Program Our readership on the 10 Ways To Tell If Your Workers Compensation Program Is In A Failure Spiral spiked very heavily last week. Some of our self insured clients asked if there were any differences for the self insureds than the regular first dollar

Will Feds Control Workers Comp In Future or Just States?

Will The Feds Control Workers Comp In 10 Years? In the future,  will the  Feds control Workers Comp. In my last post, I commented on how the Federal Government, namely CMS, is encroaching on the state-by-state sovereignty of Workers Compensation. The CMS is basically overvaluing Workers Compensation pharmacy benefits. The

Your Reserve Review Action Plan – Have You Contacted Adjuster

Reserve Review Action Plan I had posted often over the last few weeks concerning claimx`s review for insureds with a January 1, 2011 renewal date. I even included a schedule of sorts on how to proceed on a Workers Comp reserve review. I used the 1/1/2011 policy renewal date as

Experience Account (EA) Rare For Workers Comp Insuring Agreements

Term Of The Day – Experience Account Experience Account refers to a provision in an insurance or reinsurance contract that, using some function of such policy provisions such as premium, insurer charges, losses paid or payable under the contract, subrogation proceeds, and interest rates, forms the basis of an explicit or

Workers Comp File Reserves – You ARE Running Late

Workers Comp File Reserves Important To Catch Up The Workers Comp file reserves important this time of year.  I have posted over the last two weeks on the process of performing a Workers Compensation file reserve review as a way of reducing your E-Mods or X-Mods. I am using January

Multi-Jurisdictions Best Test Is WALSH For Workers Compensation Claims

WALSH Best Test When Multi-Jurisdictions Involved WALSH is best test for multi-jurisdictions of workers comp. I have posted on this subject in the past. I thought it would be good to revisit the subject after I read about a Tennessee employer that tried to have North Carolina apply Tennessee subrogation

Death of Workers Comp – CMS Now Runs FIO

CMS Now Runs FIO The CMS runs FIO – should this be death of Workers Comp?   OK, so the title is meant to catch your attention. The second part is actually a reality as of last week. The federalization of Workers Comp remains an issue. Yes, the CMS –

Endorsements Are Under Radar Part of Work Comp Policy

Endorsements Can Change Policy Many Times Policy endorsements change the policy as many times as the carrier wishes.  Workers compensation policies may need some type of change or addition during the course of the policy year. These endorsed changes for Workers Comp policies may possibly occur due to changes in

Are Policy Provisions Important?

Policy Provisions – When Reality Hits The Policy Provisions trip up employers when filing claims.  Even adjusters sometime have trouble with the policy terms.  The section of an insurance policy that defines the requirements of both the carrier and the insured. This section includes information about loss reporting and settlement,

What is A Net Loss In Workers Compensation?

Net Loss Is The Final Countdown The term Net Loss is seldom used in Workers Compensation. The figure  represents the final paid loss regardless of the reserves that were set on the claim.   The final paid loss may differ from the Total Incurred if the file was closed after the

Workers Comp Declarations Dec Page – Not That Important?

Workers Comp Declarations Dec Page Is the Workers Comp Declarations Dec Page really that important? I have often been asked by our clients what to look at in a Workers Compensation policy. In other words, they receive a huge stack of documents known as their Workers Comp policy. The policy

Workers Comp Claims Guide in 7 Words To Remember

Workers Comp Claims Guide – 7 Words To Remember A Workers comp claims guide can be broken down into seven easy to remember words.  I was posting in one of the Workers Comp forums today. I decided to bring over the concept that I posted there earlier today. Let us

Maine Makes Solid Subcontractor Rules For Workers Compensation

Maine Solid Subcontractor Rules The state of Maine makes solid subcontractor rules for Workers Compensation.The State of Maine has come up with a novel plan to identify companies/individuals that are construction subcontractors and not employees. The twelve rules for an business entity to be considered a subcontractor are spelled out

Workers Comp Premiums – Most Common Error Found

Workers Comp Premiums Most Common Error The most common error in Workers Comp premiums and policies is one that I had to think over for a few days as there are so many. We are asked this question very often. For quite some time there were so many answers that

Three Areas of Workers’ Compensation Concern In My Presentation

Workers Comp Concern  = Three Areas I have been out of action for about a week, as this is the end of our tax season. There were three areas that raised the most concern in my presentation at the North Carolina Mid State Safety Council. I will go over each

Will Workers Comp Funds Recovered Lower Our Mod?

Will A Workers Comp Funds Recovered Lower Our Mod Will a workers comp funds recovered lower our Mod this year? This question was emailed in from a blog reader from Virginia.  The rest of the employer’s question pointed out that the file was six years old. The answer to the



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