to to reduce educe the e the exposur xposure to e to of Workers - PowerPoint PPT Presentation

Wha hat the t the Emplo Employer can do er can do to to reduce educe the e the exposur xposure to e to of Workers’ Compensation cost costs s bef befor ore and e and aft after er a a claim. laim. Present esented ed by R by Robe obert t Ri Rice ce Sar Sarge gean ant Insu t Insuran ance ce Age Agenc ncy, L , LLC.

 This presentation is intended to provide some techniques to reduce the exposure and cost of Workers’ Compensation.  This discussion is not intended to be legal advice but a sharing of information from personal experience and the experience of others.  Consult an attorney or insurance professional regarding any specific issue confronting your business. State Compensation Insurance Fund

 35+ years as an insurance professional  35+ years appearing before the WCAB  25+ years as a licensed private investigator  25+ years as a certified self-insurance administrator  4 years as a licensed property casualty agent  30+ years as a small business owner State Compensation Insurance Fund

 Saf afet ety !!! !!!  Medica cal Provid vider r Network ork  Re Return n to work-modi modifi fied d or alternate ate duty  Inve nvestig stigatio tion  Communi mmunica cate te with insuranc ance ca carrier  Documentati cumentation on State Compensation Insurance Fund

Safety !!!  Have ve a written ten and enforced forced safety y program ram intended ended to provide ide employees loyees a DIRECT ECT FINAN ANCIAL CIAL INCENTI ENTIVE VE  Measure asure the emplo loyees yees succe cess s or lack k of succ cces ess s in con ontr trollin olling g inju juries/a ies/acciden ccidents  Lead ad by example mple  Instill still a positive itive healt alth h and safety cult lture ure  Ensu sure e that emplo loyees yees are involved olved in the decisio sion makin ing g proc oces ess State Compensation Insurance Fund

 1. Employees s become more focused ed on their work  2. Parti tici cipat pation ion mo moti tivates ates em employ oyee ees to to con ontribut tribute e mo more.  3. Participa ticipati tion n in dec ecision n ma making ng can hel elp em employ oyee ees to to become e more accou ountabl ntable  4. Demons nstrat trates s that you care about them State Compensation Insurance Fund

 Near misses and resulting inspections may help prevent an injury or even a fatality, but an investigation cannot take place if the near miss is not reported accurately.  Therefore, setting up a successful safety management program to ensure near misses are reported and investigated is an important step in reducing occurrences of serious incidents State Compensation Insurance Fund

State Compensation Insurance Fund

 Gives the employer/insurance carrier unlimited medical control.  Doctors are trained in reporting requirements  Doctors are usually more accessible to the employer’s input  Better opportunity for prompt return to work  Significantly reduces medical costs in a litigated case. State Compensation Insurance Fund

 At the time the employee oyee is hired or when a ne new insur uranc ance ca carrier r is obtained ined the employe yee(s) (s) must t be notified of the employer’s MPN.  In English sh and in Spanish sh (required) red)  Incl clude ude a Predesi esignation gnation Form, , in English sh and Span anish. ish.  Have ve the employe yee sign the ack cknowl owledgemen edgement t form m which ch should ld also be in English sh and Spanish sh an and signed ed in thei eir nat ative ve lan anguage uage  Ta Take a p photogra ograph ph of the employe oyee holding ng the MPN N pack cket. et. State Compensation Insurance Fund

State Compensation Insurance Fund

State Compensation Insurance Fund

State Compensation Insurance Fund

State Compensation Insurance Fund

 Faci cili litate tate returning ning injured ed workers rs to work  Of Offer er modifie fied d or al alter ernate ate work ◦ Does not have to be enjoyab yable le or pe permanent nent ◦ Shoul uld have to ha have some benefit it to t the employer yer  Create e modifi ified ed or alterna nate te work job bank and written ten job des escr cription iption for ea each ch  Always s co communicate municate with your employee oyee and the doct ctor( or(s) s) in writing ng that alterna nate te or modifi fied d work is available able.  Keep p your insura ranc nce e adjuster ter informed rmed of modifi fied d or alternat nate e work availabi ability lity State Compensation Insurance Fund

 Prompt mpt interna ternal l inve vest stig igatio ations s are cruc ucia ial  Disputed puted claim ims need ed an aoe/coe coe inves vesti tigat gatio ion ◦ This starts with the Employer investigation and documentation  Recomm ecommen end d Surveil veillan lance ce inve vest stiga igatio ion early in the claim ims proc oces ess ◦ The insurance carrier far too often waits to undertake sub-rosa investigation. Provide them a reason, in writing, as to why surveillance would be beneficial… FRAUD ? State Compensation Insurance Fund

 Monitor the claims activity  Push disputed cases to a prompt disposition including Trial  Monitor reserves and claim closure  DO NOT DEPEND ON THE INSURANCE COMPANY TO ALWAYS PUT THE EMPLOYER’S INTEREST FIRST State Compensation Insurance Fund

 The common HR rule is to document everything  Serves you very well in Workers’ Comp ◦ Employer can seek relief from the insurance carrier for improper claims handling Should a case go to Trial, you as the employer are prepared to influence the Judge State Compensation Insurance Fund

Th Thank nk you for your r atten enti tion!! on!!  Rob ober ert Ric t Rice  Sar Sarge gean ant t Insu Insuran ance ce Age Agenc ncy, , LL LLC. State Compensation Insurance Fund