So
What Does Your Comp Group
Program Administrator Offer You?
Armstrong & Associates
and CDTOA Team-up to Provide
CDTOA Group Members
With Maximum Service
CDTOA
Group Workers’ Compensation Members
Receive VIP Account Status for Claims Management
As part of Armstrong & Associates/CDTOA’s commitment to excellence,
the Armstrong Claims Management Team headed by Senior
Workers’ Compensation Claims Analyst, Dan Bertrand Ph. (800) 632-2777 and other seasoned
professionals in the workers’ compensation
field will implement our claims management program
with a strategic approach based on Management
and Quality Control. This comment sets Armstrong and
CDTOA apart from the rest of the Workers’
Comp Groups. We are committed to handling each
comp claim as aggressively and proactively as
the laws allow. Make no mistake, your claim is
OUR claim, and it will be handle that way.
With
or without State Fund’s Staffing issues, claims management is
the key to controlling workers’ comp losses.
Here’s how we intend to reduce your comp
costs.
Four
Essential Aspects of the Program Are:
- Tracking and close monitoring of all your
open workers’ compensation claims that will
impact your experience modification. Upon knowledge
of a claim, the data will be automatically entered
into our automated claims system in order to commence
the claims management process immediately.
- Interaction with your Insurance Carrier. Our
claims management team will work closely with
your insurance carrier on an ongoing basis, not
after a problem arises. Through their expertise,
we have the resources to fight fraudulent claims
and reduce reserves as necessary.
- Consistent and Timely Reports: You will receive
quarterly claims status reports tailored to your
needs when you need them detailing follow up points
to bring the claims to final resolution.
- Assist in your early Return-to-Work Program:
Our claims management team will act as mediator
between you and the insurance carrier to assist
in the early return to work of your injured employees.
They will coordinate with the examiner on your
behalf to explore the possibility of an alternate/permanent
modified work to limit financial exposure.
Claims Disposition Services
A. Claims Reviews:
- Pre-Unit Statistical – two months
prior to Unit Statistical filing
- Unit Statistical filing – six months
after policy expiration
B. Claims Status Reports:
- Quarterly audit is performed on all open
claims from this point forward as well as more
detailed audits for the annual Unit Statistical
filings
- Client notification of reserve changes
over $20,000
- Client notification of vocational rehabilitation
- Client notification of permanent disability
ratings and settlements
- Client notification of litigation
C. New Claims
- A verbal plan of action will be obtained
from the carrier within 90 days after receipt
of notice of claim and as it appears in the loss
experience report.
D. Client Responsibilities
- Notify USI of changes in work status as
needed
- Notify USI of fraudulent or suspicious
behavior from the employee
- Notify carrier of any disputed or questionable
claim from the onset
- Notify or report the claim within the five
(5) days of the date of injury.
E. Claims Monitoring of Prior
Policy Years
- Obtain current status for all open claims
on prior policy years affecting your experience
modification
- Obtain periodic verbal updates from carriers
on specific issues and/or reserves
F. Workers’ Compensation
Insurance
Rating Bureau (WCIRB)
- Appropriate documentation will be sent
to the WCIRB within the legal timeframe if errors
are found in the experience rating forms detailing
the parameters and justifications to warrant corrections.
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