Using Loss Data to Reduce your Workers Comp Cost

Using claims and loss data can be a helpful tool in reducing your future workers compensation losses.  Two types of forms that are readily available are your OSHA logs and your Loss Runs or Claims Reports from your Insurance Carrier. 

If you maintain your OSHA log year round, as required, it’s a great tool to provide you with information on where your claims are coming from.  It will give you dates, job titles, types of injuries, and days away from work.   The OSHA 301 will contain even more detailed information.  You can combine this with the Insurance company loss runs to obtain a good amount of information to track and trend.  I recommend an accident investigation form be used that contains all the needed information to complete all of your forms after an injury.   There are also several online OSHA tracking programs such as OSHATrac.com  and OSHA300Online.com  that will track your injuries and give various reports.

If you have more than a few small claims, Insurance Carrier loss runs should be provided to you either quarterly or monthly.  The loss runs can be very basic so I would recommend asking the broker or carrier what reports are available.  Some will have very detailed reports available if you ask.  They will show many types of graphs and trends.  If your broker makes it hard for you to obtain this information, you could have the wrong broker.   In addition to trending, the loss runs will give you good information on what’s going on with the claim since the last loss run.  Look for changes in numbers such as paid (amounts already paid on a claim) and reserved (estimates of amounts expected to be paid on the claim) on all open claims.  We will discuss this in detail in another article. 

This information should be reviewed regularly by the CEO, HR Department, Safety Department, and Safety Committee.  They should all be looking at ways to improve your safety and prevent losses in the future by noticing trends.  An example might be that all claims in the certain department were from employees there under 1 year.  This would mean that they lack proper training and supervision and the training program could be altered to improve this situation.   

In addition to looking at past claims to identify a possible future claim, the claims information can be used for actuarial analysis to predict future losses.  This is very important if you are under a partially self funded plan or in a captive because it will allow you to predict your claims numbers in the future.  The more data that is available, the better the analysis will be.  Some auditors may request or require this information when performing your annual audit. 

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.

Choosing Medical Providers for Workers Comp


How you choose and work with Medical Providers is a key component in reducing your Workers Compensation costs when an employee is injured on the job.  This should be a process similar to hiring a good employee who will become a crucial part of your team.  I recommend the following: 

  • Be sure you understand your state law concerning Work Comp
  • Most states allow you to choose the medical providers for Workers Comp injuries.
  • If possible, choose a Medical network of doctors after your policy is written.  Many insurance companies offer networks of Occupational doctors who are very accustomed to dealing with workers compensation claims and insurance companies.  Work Comp is much different than health insurance, so it’s important to work with the appropriate doctor or clinic.  Usually, there are Occupational Medical Clinics in larger cities.  In smaller towns, employers may send employees to a local physician when they are injured. 
  • Each of your locations should know which physician or clinic an injured worker should go to, their phone number, and address.  I recommend posting this somewhere employees can easily see it, such as a bulletin board or in the break room. 
  • Each location should also have the nearest hospital and emergency number (if not 911) readily available for injured employees.  This should also be posted. 
  • Set up a meeting with the physician’s office or clinic in advance and let them go through their procedures with you.  Tell them what you expect, and find out what they expect.
  • Get a list of the provider’s staff who handles work-related injuries, as well as their contact information.
  • Let the provider know if you have an Early Return to Work Policy (ERTW) or Alcohol and Drug Testing Policy.  Give them job descriptions of your most common worker classifications. 
  • If you don’t have frequent work-related injuries, schedule annual meetings to keep your medical provider up to date with your procedures.
  • If you have certain specialist(s) in the area you prefer to use, make sure your provider knows your preferences.  If not, ask the provider who they use.  This also applies to Physical Therapists.  Ask if they own their own PT practice, MRI facility, etc.  This lets you know of any possible conflicts. 
  • Communicate to your employees who your local clinic or physician is and remind them of your ERTW Policy (if you have one).  This should be done on an annual basis and for all new hires. 
  • If you are having trouble finding a provider, ask a medium-to-large company (50+ employees) in the area who they recommend. 
  • Do not allow employees to choose their own provider unless you have approved them in advance. 
  • Find out the provider’s policies on using pain killers. You want to keep this at a minimum. 
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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? - 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

Comment

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 State Supreme Court Upholds Mutualization of Compsource Oklahoma

A unanimous Oklahoma Supreme Court ruled Tuesday against Tulsa Stockyards’ challenge to a 2013 law that changed CompSource Oklahoma into a mutual insurer for workers’ compensation insurance purposes.
 
The stockyards company argued that the restructuring of the former state workers’ comp insurer violated provisions of the Oklahoma Constitution that prohibit making gifts of public money, interference with contracts and paying money out of the state treasury except by appropriation.
 
The law becomes effective on Jan. 1, 2015.


Comment

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 Workers Comp Commission New Web Site up

The website for the newly established Oklahoma Workers Comp Commission is up and running.  Some things to know:

  • Forms Page - This are for new forms for any claim after 2/1/14.  Some of the forms have changed very little from the workers compensation court forms.  This is only temporary until the commission has time to roll out new forms that are more "user friendly".
  • Rules Page - These are the new rules that go along with the new law.  These are emergency rules and will be changing as things develop.
  • Commissioners - In case you are wondering who the new commissioners are, their bios are here.  Only 1 is an attorney.  
  • Workers Comp Certificate of Non-Coverage/Affidavit of Independent contractor Status - This form is not been released yet.  It will be more like the latest form that the insurance commissioner was using instead of the old form of the past.  It does not look like their will be a charge for this form at this time.   

More info will follow as it is developed - 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.

Supreme Court to Hear Arguments on SB1062 - Workers Comp Reform

The Case heard before the supreme court on SB1062 will now go before the supreme court.  This would seem to give the case against the bill more validity.  

photodune-6185642-paper-folders-and-gavel-xs.jpg

Yesterday, the Oklahoma Supreme Court announced it will assume original jurisdiction of this law suit.  The court also directed that oral arguments to the full court be heard on Tuesday, December 10, 2013.  Both parties (for and against the 2013 reforms and the Option) will have an opportunity to present their case and respond to questions from the justices.

In the event part of all of the law is overturned, it's expected the Legislature will act quickly to pass smaller bills to offset any negative decision.  

Comment

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 Department Issues Draft of Rules for "Oklahoma Option"

Below is information taken from OID website that explains the new rules and process to make them final: 

The rules posted below are still in draft form and subject to change at any time. The Department will make its official proposed rules and rule impact statement available for public comment on December 2, 2013. Public comments may be submitted until December 18. On December 19, the Department will hold a public hearing on the proposed rules. If you have any questions or concerns before December 2, please feel free to contact any of the individuals listed on this page.

Draft Rules for Oklahoma Option Download

 

Dan R. Byrd

 Assistant General Counsel

405-522-6330

fax: 405-522-0125

dan.byrd@oid.ok.gov

 

Buddy Combs

Assistant General Counsel

405-522-26335

fax: 405-522-0125

william.combs@oid.ok.gov

 

Brant Cale

Financial Specialist

405-522-2374

brant.cale@oid.ok.gov

  


Comment

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.

Governor Appoints 2 new members for new Workers Comp Commission

Oklahoma City attorney Robert H. Gilliland and Denise Engle, workers compensation deputy insurance commissioner, have been appointed to the Oklahoma Workers’ Compensation Commission.

This brings the total Commission Members to 3,  including the previously appointed Chairman, Troy Wilson.  The Senate will be required to confirm each appointee. 

The three Commissioners will develop rules to be in place when the workers comp law takes effect on 2/1/14.  SB 1062 also allows them to create emergency rules if needed.  

Gilliland will serve a four year term and Engle will serve a 2 year term.  Wilson, will serve a 6 year term.   

Comment

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.