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ARI Blog: Article

Restoration Insurance: Three Ways to Control Workers Comp. Costs


Cost control and injury management are the basic yet most essential management programs that impact workers’ compensation loss costs.

Focusing efforts on prompt claim reporting, controlling medical costs, and having a plan to get injured employees back to work as quickly as possible can impact controlling your workers’ compensation claim costs.

1. Report claims promptly.

The prompt reporting of employee injury claims can be one of the most effective tools in controlling worker’s compensation costs. Delays in claim reporting can lead to inappropriate medical treatment delays, impacting the cost of medical care, recovery time, wage replacement, and return-to-work opportunities. For example, the longer a strain injury goes unreported, and medical treatment is delayed, the worse the injury can become, resulting in more costly types of medical treatments and longer recovery times.

Employers and employees both must understand the following benefits of prompt claim reporting:

  • Enhances claim adjusters’ ability to make immediate contact with the injured worker and their ability to provide appropriate medical management

  • Decreases the likelihood of fraud by preserving investigative facts that may affect compensability

  • Facilitates medical case management opportunities that can help to reduce medical and lost time costs

  • Provides for the timely delivery of benefits – a key concern to injured employees

2. Utilize network medical providers. According to current NCCI data, medical costs represent 58% of workers’ compensation claim costs. Utilizing network providers is a critical step in controlling your medical costs. Channeling treatment to a preferred provider will help ensure that injured employees receive quality medical care and that the physician’s return-to-work (RTW) is addressed as soon as medically appropriate.

3. Plan for return-to-work with a well-engineered process. An essential tool for controlling claim costs is an effective return-to-work process. Lost time or indemnity cases have the highest percentage of uninsured indirect costs. Prompt return-to-work by accommodating medically restricted employees the same day or day following the physician’s release can reduce the medical, indemnity, and legal fees associated with workers’ compensation claims, which will, in turn, impact your company’s bottom line.

To measure the success of your return-to-work program, use this formula, and watch your results improve as employees are accommodated:

Total # of claims with employees working modified duty÷total # of open indemnity claims = % of Your return-to-work (RTW) success

Focusing on these three areas of reporting claims promptly, utilizing network medical providers, and planning for return-to-work can reduce your workers’ compensation overall claim costs and improve your bottom line.

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