Get the most out of workers comp claims management

To successfully manage a relationship with workers compensation claims adjusters or third-party administrators, middle-market employers should remain involved in the claims process but recognize when to let the experts do the work for which they were hired. Below are some tips from experts in the workers comp field on getting the most out of the claims management services:

• Smaller firms should consider using regional or local TPAs to prevent getting “lost in a file cabinet.”

• Employers should ask for on-site visits from claims adjusters to facilitate familiarity with the organization's business model and risk profile.

• Employers should establish a clear set of service expectations with the adjuster and conduct regular evaluations of their performance in meeting those expectations.

• To ensure the employer is perceived as a client, employers should develop a personal rapport with the claims adjuster.

• Employers should treat the adjuster or TPA as a part of an in-house risk management team, instead of an external agent.

• Employers shouldn't take it personally when an adjuster or TPA advises against their preferred course of action.

• Employers should provide their adjusters with as much accurate information about the claimant and the nature of the injury as soon as a claim arises.

• If an employer suspects that an employee has submitted a fraudulent claim, it should inform its adjuster or TPA but be prepared to provide hard evidence to support the allegation.

• Employers should keep abreast of law changes and developments the workers comp arena; continuing education courses and industry seminars can be useful.