Oklahoma Option Savings? - Reduction in Fraud

If you are an employer that has had several claims, it's likely that you have seen multiple cases of what you might consider fraud. Some reasons employees do this include:

  • To get an off the job injury covered under workers compensation.  Workers with no medical coverage are prime for this and also workers comp has no deductible. 
  • To obtain a lump sum settlement.  We have seen some employees with over 10 workers comp claims all involving settlements and all involving the same attorney.
  • To obtain pills - Opioid abuse is at an all time high and Oklahoma is one of the worst states for this.  Many work comp doctors will prescribe a complete battery of pain killers which the injured employee may either sell on the black market or take themselves.

I break this down into complete fraud, in which the employee fabricates the entire injury, or modified fraud in which the employee gets legitimately injured and is then swayed by an attorney, friend, or coworker to modify their symptoms to obtain one or more of the above.  

The Oklahoma Option makes attorney involvement much harder for the average attorney who is used to dealing with the workers comp system because most claims will routinely be referred to Federal Court due to ERISA (Employee Retirement Income Security Act), which regulates these types of workers comp plans.  This can actually benefit the employer.  

The Oklahoma Option also greatly reduces the time for reporting a claim because employers can choose reporting requirements under this type of benefit plan. This will curtail the past practice of reporting claims months or often years after the claim allegedly happened.

Chris Moxley

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Chris Moxley

Chris began his career at a Norman insurance agency in 1988 serving as a Branch Manager for 3 years. He joined Professional Insurors in 1995 as a Producer and became Vice-President in 2004, where he overseas human resources and agency operations & technology as well as continuing to manage his client accounts and grow the business. The Agency works with a variety of accounts and Chris specializes in Workers Compensation Risk Management and Insurance. He has worked in Insurance for over 20 years and besides Workers Compensation he has specialized training and experience in the fields of Construction Risk Management and Risk Transfer, Property Management, & Manufacturing.

Work Comp Update - Oklahoma Option

As of today there have been 2 small companies and 1 large company approved and written under the new "Oklahoma Option" according to Partnersource of Texas.  Several more have obtained quotes, but have yet to be approved by the Insurance Comissioner's office.  According to the insurance commissioner there are 3 insurance carriers now offering quotes to various size Oklahoma business'.  They are reporting premium savings over the new administrative system.

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Chris Moxley

Chris began his career at a Norman insurance agency in 1988 serving as a Branch Manager for 3 years. He joined Professional Insurors in 1995 as a Producer and became Vice-President in 2004, where he overseas human resources and agency operations & technology as well as continuing to manage his client accounts and grow the business. The Agency works with a variety of accounts and Chris specializes in Workers Compensation Risk Management and Insurance. He has worked in Insurance for over 20 years and besides Workers Compensation he has specialized training and experience in the fields of Construction Risk Management and Risk Transfer, Property Management, & Manufacturing.

Oklahoma Option Savings? - Medical Management

Many people are wondering where the savings are in opting out of Oklahoma's Workers Comp system and managing their claims through the "Oklahoma Option" Employee Injury Benefit Plan? We will be looking at some of the areas of savings over the next few articles.  Today we will focus on medical management.

Anybody that works in workers compensation will tell you that the medical management under the Workers Compensation system is one of the biggest problems. While several factors may be to blame, many doctors will not see employees with workers comp claims, which sometimes results in a battle of dueling attorney's and physicians.  Conversely, the "Option" encourages more doctors to treat injured workers as the claims may not always be viewed as workers compensation. For example, wear and tear injuries, such as knee replacements, may often be denied as these should be covered under medical insurance. Therefore, the result is more positives outcomes for all, such as better managed claims according to best practices, reduced attorney involvement, and ultimately getting the employee back on the job as quickly as possible.  

While early reporting has historically been encouraged, under the Oklahoma Option, it is often required. Employees may be required to report an injury in as little as 24 hours. Early reporting has several advantages: it allows the employer and treating physician(s) to better assess and treat the injured worker (decreasing chances of an aggravated and/or escalated injury), it tackles any workplace safety concerns by being proactive, it prevents potential fraud, it returns the employee to work sooner, and it helps the employer with cost containment associated with claims loss ratios, insurance premiums, and safety programs; and let's not forget employee morale! 



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Chris Moxley

Chris began his career at a Norman insurance agency in 1988 serving as a Branch Manager for 3 years. He joined Professional Insurors in 1995 as a Producer and became Vice-President in 2004, where he overseas human resources and agency operations & technology as well as continuing to manage his client accounts and grow the business. The Agency works with a variety of accounts and Chris specializes in Workers Compensation Risk Management and Insurance. He has worked in Insurance for over 20 years and besides Workers Compensation he has specialized training and experience in the fields of Construction Risk Management and Risk Transfer, Property Management, & Manufacturing.

Oklahoma Insurance Commissioner releases Opt-Out Forms

The State of Oklahoma Insurance Commissioner has released some initial forms to be used to apply for the Oklahoma Option or Opting out

At this point it is difficult to simply look at the application form and decide what they may be looking at to approve or deny any particular company.  As I laid out in my prior article, there are still a lot of questions to be answered.  Rules are still being formed and will have to be approved to determine what the qualifications are.   

Here they are: 

Qualified Employer Election Form (opt out application) 

Qualified Employer Sample Certificate

Qualified Employer Notice Employers

 

Also find them on our RESOURCES Page along with other good information

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Chris Moxley

Chris began his career at a Norman insurance agency in 1988 serving as a Branch Manager for 3 years. He joined Professional Insurors in 1995 as a Producer and became Vice-President in 2004, where he overseas human resources and agency operations & technology as well as continuing to manage his client accounts and grow the business. The Agency works with a variety of accounts and Chris specializes in Workers Compensation Risk Management and Insurance. He has worked in Insurance for over 20 years and besides Workers Compensation he has specialized training and experience in the fields of Construction Risk Management and Risk Transfer, Property Management, & Manufacturing.