California Construction Trucking Association (CCTA)

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 handled 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:

1. 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.
2. 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.
3. 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.
4. 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 Armstrong of changes in work status as needed
• Notify Armstrong 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.