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Teamwork aids resolution of tough workers comp claims

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Teamwork aids resolution of tough workers comp claims

PHILADELPHIA—Employers, adjusters, insurers and others involved in handling workers compensation claims should work together as a team to manage cases and avoid significant losses, experts say.

Mary Proietti, risk manager of Lake Forest, Ill.-based Packaging Corp. of America, said the packaging manufacturer has used that sort of collaborative effort to settle some of the company's longstanding workers comp claims—some of which date back to 1984.

She was one of several panelists who spoke at the Risk & Insurance Management Society Inc.'s conference in Philadelphia during a session titled, “Claims Triage: Identifying and Settling Big-Ticket Claims.”

By consulting with the company's excess workers comp insurer and claims adjusters, Packaging Corp., which has a $1 million self-insured retention, has been able to mitigate losses in some of its most difficult claims, Ms. Proietti said.

“My responsibility is to get everyone with expertise involved in the process,” said Ms. Proietti.

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It's important for employers such as Packaging Corp. to identify and intervene in high-cost workers comp claims before they spin out of control, said Donna Urbanski, a Southington, Conn.-based independent claim consultant.

“Every $100,000 claim in (the) portfolio is potentially a $1 million claim,” she said.

While medical expenses are the largest portion of high-cost workers comp claims, companies can help limit those losses by working with consultants that specialize in medical or prescription management, Ms. Urbanski said.

Insurers can provide key connections to consultants for companies that need the assistance, providing early intervention that can help companies gain control of their workers comp costs, she said.

“That's why it's crucial to use your carrier as a resource,” Ms. Urbanski said.

Greg Gitter, president of San Diego-based Gitter & Associates Inc., a consultant that works to resolve high-exposure workers comp claims, said creativity is a key strategy when crafting settlements to close long-term claims.

For instance, his firm worked with a claimant who was reluctant to settle for $50,000. During a meeting, the worker mentioned to Mr. Gitter that he enjoyed bass fishing.

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So the consultant offered the worker a settlement of $8,000, plus a new bass-fishing boat that the company purchased for $38,000. The claimant readily accepted that offer, Mr. Gitter said.

“We were able to provide this man with exactly what he wanted,” Mr. Gitter said. “It's about listening to what these people have to say.”

Mark Walls, St. Louis-based vp of claims for Safety National Casualty Corp., agreed that flexibility in settlements can help close claims that otherwise could result in high costs that last for a worker's lifetime.

“Drawing a line in the sand never works out well for you,” said Mr. Walls, who moderated the panel.

He said it's also helpful to provide claimants with specific settlement amounts to help them weigh whether such a deal would work for them.

“It's a lot more difficult to reject a number than it is a concept,” Mr. Walls said.

Panelists said there are early steps employers can take to identify and intervene in potentially problematic workers comp claims.

For instance, Mr. Gitter said companies and insurers should identify co-morbidities—such as smoking or diabetes—that could complicate medical treatments for a work-related injury.

Employers also should maintain communication with injured workers to stay up-to-date on their recovery, panelists said. Such discussions can help workers feel valued and encourage them to get back to work.

“That level of communication from the beginning has such an impact on changing the entire course of the case,” Mr. Gitter said.