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  • Essential Property and Liability Insurance
    • All Property & Liability Topics
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  • Specialized Insurance Policies
    • All Specialized Prop & Liability Topics
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5 Shots Of Tequila Does Not Always Equal Denied Work Comp Claim

October 14, 2015 by The Insurance 411Leave a Comment

Imagine the following scenario when handling a workers’ compensation claim: John Doe is a construction worker who shows up for work on Monday morning appearing to being “a little off his game.” Shortly after starting work he falls from some scaffolding and suffers a severe work injury.  Following the accident, he was taken to a...
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Theme: Recommended, Workers Comp

Warning To Employers: Cost Transfer Of Medical Benefits To Workers Comp

October 5, 2015 by The Insurance 411Leave a Comment

The Worker’s Compensation Research Institute (WCRI) has issued a report that workers treating doctors will have an economic incentive to transfer treatment from the Affordable Care Act to workers’ compensation. Similar transfers have been going on for decades but they started when workers initiated the transfer to take advantage of the potential of a settlement...
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Theme: Recommended, Workers Comp

Effective Use of Functional Capacity Evaluations

September 26, 2015 by The Insurance 411Leave a Comment

It is important for claims management teams to make effective use of Functional Capacity Evaluations (FCE) in workers’ compensation cases.  Failure to do so can result in losing control of your case. What is a Functional Capacity Evaluation? A Functional Capacity Evaluation (FCE) is a series of tests performed on an injured worker to determine...
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Theme: Recommended, Workers Comp

Using Job Descriptions to Control Workers Compensation Losses

September 24, 2015 by The Insurance 411Leave a Comment

Complete job descriptions, with proper compliance can help reduce workers compensation loss values. They can be used both as preventative measure and as a tool to reduce a claim exposure.  Job descriptions that are stated clearly, as well as describe all duties and functions, will bring the most desired results. Preventative Uses: Job descriptions can be...
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Theme: Recommended, Workers Comp

California WCIRB Notes Proposed Rating Changes

September 22, 2015 by The Insurance 411Leave a Comment

Recently, the WCIRB submitted a regulatory filing to the California Department of Insurance proposing a number of changes to the Insurance Commissioner’s regulations. Among the proposed changes is a recommendation to amend the experience rating formula to replace the fixed primary and excess split point with a variable split point based on an employer’s size....
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Theme: Recommended, Workers Comp

Understand And Improve Your Experience Modifier

September 5, 2015 by The Insurance 411Leave a Comment

To calculate your workers compensation insurance premium, the insurance company takes into consideration three things – the type of business you are in, the total amount of your company’s payroll and your experience modifier.  The only one of the three things the employer has control over (without reducing payroll) is the experience modifier (also referred...
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Theme: Recommended, Workers Comp

Understanding Medicare Advantage Plans in Your Work Comp Case

September 4, 2015 by The Insurance 411Leave a Comment

Medicare Advantage Plans (MA Plans) are growing in popularity and currently cover about 30% of all Medicare beneficiaries.  This is partly due to the fact MA Plans provide numerous coverage options for people with various medical needs. The increasing use of these Plans has created confusion for claim management teams as they handle workers’ compensation...
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Theme: Recommended, Workers Comp

Small Percent Of Claims Create Large Percent Of Costs

September 3, 2015 by The Insurance 411Leave a Comment

Twenty percent of all workers’ compensation cost is incurred on less than one percent of the claims.  These high dollar claims are often referred to as catastrophic claims.  The term ‘catastrophic claim’ applies to the nature of the claim, not the dollar cost, even though the severe nature of the claim and the high dollar...
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Theme: Recommended, Workers Comp

Defense Attorney Often Over-Looked as Cost Containment Strategy

September 2, 2015 by The Insurance 411Leave a Comment

The proper selection of defense attorneys is one of the most important things a self-insured employer can do to control cost of the larger workers’ compensation claims.  It is also one of the most over-looked ways to control claim cost.  Whether you are new to the world of self-insurance, or just not happy with the...
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Theme: Recommended, Workers Comp

Permanent Partial Disability In Workers Compensation

September 2, 2015 by The Insurance 411Leave a Comment

The objective of the medical providers in every workers’ compensation claim is to assist the injured employee to recover completely or to the greatest degree of recovery that is possible.  Unfortunately, there are injuries where the employee does not recover fully from the effects of the injury.  When an employee reaches maximum medical improvement (the...
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Theme: Recommended, Workers Comp

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