Insured:
The insured is social service agency in Massachusetts with 390 employees in 22 locations. The organization provides occupational training and rehabilitation services to developmentally disabled adults.

Situation:
In one six-month period, this insured experienced 27 workers’ compensation claims totaling $89,000.
Assessment: A Certified WorkComp Advisor (CWCA) looked into the situation and discovered supervisors played no role in managing their employee injuries. It was left to the employee to seek medical attention and return to work when their doctor recommended it.

Employees routinely went to the emergency room or to their personal primary care physician. These doctors ordered lengthy periods of rest and made no effort to assess the employee’s work capacity. Supervisors made no effort to stay in touch with employees or return them to work on modified duty.

Solution:
On May of 2006, a Certified Work Comp Advisor conducted a training session with the organization’s 34 supervisors. The training explained how claim costs impact workers’ compensation insurance premiums; how to work with an occupational medical clinic; and how to support and manage a comprehensive recover at work program.

With this new awareness, supervisors took steps to resolve safety issues and employee behavioral problems. They began directing employees to an occupational clinic whenever possible. They stay in contact with employees during any disability and actively seek opportunities for modified duty.

Result:
In the 6 months since the training, the insured’s claim frequency has been cut in half (only 11 claims). Amazingly, these 11 claims total less than $1,000. The CWCA is now planning a celebration to congratulate the insured’s supervisors for this remarkable turnaround.

Insured:
The insured is a large commercial and residential real estate developer in Rhode Island.

Situation:
An employee suffered a laceration to his finger while using a saw. The carrier set the highest possible reserves for disfigurement, permanent loss of use, and temporary disability warranted for this type of injury.

Assessment:
Knowing that insurance carriers routinely set high reserves on claims and keep those reserves active until the claim is closed, a Certified WorkComp Advisor (CWCA) resolved to keep close tabs on every aspect of the claim. Along with skilled in-house claims specialists, the CWCA worked with the employer, medical providers and claims adjusters to continually assess the case and adjust reserves accordingly.

Solution:
As soon as the employee was released to full duty, the CWCA asked the insurance carrier to remove any remaining reserve for disability. A short time later, the carrier made a payment to the employee for scarring, and the CWCA requested they remove any remaining reserves for disfigurement. Later, the CWCA argued successfully to lower reserves for permanent loss of use.

Result:
By the insured’s next valuation date, reserves on this claim had been lowered by more than $57,000. As a result, the client’s experience mod rating was 19 points lower than it otherwise would have been. This resulted in a premium savings of more than $4,000 annually.