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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 claims review amounts to knowing which claims to pick and which ones to leave alone.  Calling attention to certain claims can hurt reserves.  

Setting reserves levels can be more of an art form than a routine task.   We reviewed many analytics software programs over the years.  Not one can accurately assess the level of reserves.  

Too many variables exist in a Workers; Compensation claim for analytics to work properly.  

Medical healing periods vary by each person.  No two injured workers heal the same way.  The healing time assessment requires the keen eye of an experienced adjuster.  

An experienced adjuster usually has 5 -7 years of claims adjusting experience at a minimum.  

Adjusters by the nature of their job are very overloaded.  Adjusters maintain 13 tasks in their jobs.  Any assistance that an employer gives to an adjuster usually results in a lower claims reserve level.  

Claims reviews are not easy tasks to perform.  One of the keys to lower worker’s comp costs occurs when the employer takes the time to become interested in their claims.  

J&L’s claim review services include:

  • Claims loss run analysis
  • Reserve analysis
  • Choice of which claims to contact adjuster on
  • Performance analysis – how did the adjuster handle the file?
  • LDF analysis for self insureds 

Our claims review services keep in mind that we had sat in the adjuster’s seat at one time.  Our review services always keep that in mind. Most of our competitors do not consider “the seat.”

If your company wishes to DIY the review, make sure you have an up-to-date loss run at the very beginning.  

Claims Review


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