Let’s further discuss when you have hired employees and what you can do to mitigate worker’s compensation claims.
You need to remember the following; You either will soon be assigned a Worker’s Compensation Experience Modification. This may be a foreign word to you but when you achieve a certain earned premium level over a period of time, you then will be subject to the insurance company rates for each classification of employee to be either surcharged or credited depending upon the experience modification issued by an outside authority who has judged 3 years of your claims history… Now begins the interaction with your insurance company, its’ claims adjustors, its’ attorneys, health care provider and the attitude of your injured employee.
The attitude of your injured employee is a real driver in what your worker’s compensation premiums will be in the near future. Their claims whether they be for weekly indemnity (i.e.: a weekly payment for a percentage of their lost wages), or their medical and rehab care comes a matter of the insurance carrier estimating what that claim will cost after it is fully completed and the employee’s claim is satisfied and closed. THE DOLLAR FIGURE THAT THE INSURANCE CARRIER IS GOING TO CHARGE AGAINST YOUR POLICY DEPENDS UPON THE INSURANCE COMPANY’S EXPERIENCE FOR SIMILAR CLAIMS AND THE ATTITUDE OF THE CLAIMS ADJUSTOR DURING THE DAY THAT THEY ADJUST THESE RESERVES FOR THIS LOSS. (Watch out for this…)
It is the job of Bone Robertson & McBride Inc as your Worker’s Compensation Insurance Broker that we interact with you and the claims adjustor after the end of each policy year in order to negotiate the open guesstimates for each claim that has yet to be fully satisfied. We’d like to think of this negotiation as “closet credits”. It is kind of like they go into the closet, they talk to themselves and depending upon whether they have had a good day personally or at the office, they come out with a willingness or lack of willingness to change a claim based upon the information provided by you and/or Bone Robertson & McBride Inc.
I know the above sounds silly, but this is the reality of this unfortunate insurance product that is forced upon you by law. The claims negotiation and its reserves is so important it will affect 3 years of your insurance cost based upon the finality of this negotiation and future negotiations over the coming months for claims that still remain open. You and Bone Robertson & McBride Inc. need to batter down the insurance company over the cost estimate and cost of these claims.
In addition to the above negotiations with the insurance carrier, you also have the potential right to inject your thoughts to your insurance carrier as to acceptable treatment plans in spite of the attending health care provider’s thoughts on the matter. Many times it becomes known that the injured employee has persuaded the health care provider that he is more injured than he really is. You the employer may have knowledge to the contrary and thru the insured’s adjustor’s assistance can at times help modify the health provider’s routine to a less costly format if such is viable with this new knowledge.