4 Basic Areas of Self-Insurance Management

There are four basic areas of concentration that we believe are important to managing your self-insured workers’ compensation exposure:

 

1. Administrative Processing:

Review and payment of benefits, whether they are medical or indemnity, is an important aspect of your program. This is the one area in which your TPA likely offers you the most service. 

 

2. Claims management:

This is the area where your TPA should offer you the most support. millisor + nobil offers consulting and audit services to make sure your claims management program is operating at its optimal level.  These include:

 

• Reporting: Ideally, first notice of injury should be given to the adjuster within 24 hours of an accident. We offer policies, procedures and educational sessions for our clients and their employees to make sure accident investigation results in the opportunity for reductions in current and future costs.

   

• Compensability: This should be determined by the employer and the adjuster, with the assistance of millisor + nobil in the case of more involved incidents.

 

• Investigation: This review view of activity after the initial notice of loss is received should include contact with treating physician and claimant.

 

• Controverted Claims: The sooner legal counsel is involved when there is a dispute between the employer and the employee, the better the opportunity of success.

 

• Subrogation: When third parties are at fault, it is important to initiate an aggressive subrogation recovery process as quickly as possible.

 

• Contract Compliance:  Do your service providers operate within the terms of the contract you signed?  Are you getting all the services that your contract stipulated?  We work with our clients to insure strict contract compliance.

 

3. Financial Review:

We will support your own strong internal resources on an audit basis to create a more accurate picture of reserves necessary to support future claims costs.

 

We help both externally- and internally- managed programs focus on creating an accurate financial picture. millisor + nobil will help you evaluate the process and address the following:

 

• Use of Standardized Reserves: The only standard reserve recommended is for medical only claims.

 

• Contingent Reserving: Is the adjuster placing contingent reserves on files currently in litigation?

• Short-Term vs. Long Term Reserving: How long after the accident is a present value of the future projected cost established?  How does the established reserve value-track in terms of actual costs (both on an individual claim and program basis)?

 

• Reserve Growth Patterns: How are past liabilities being managed?  This includes settlement practices and valuations of claim liabilities closed but not statutorily dead.

• Specific Excess Insurance: How does specific excess insurance impact reserves? 

 

4. Litigation Support:

Throughout the process, our lawyers focus on achieving the optimal financial and organizational outcomes for our clients. We are aggressive, but never lose sight of the final goal of cost control.