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Want Faster Workers Comp Claim Resolution? Don’t Annoy Your Adjuster!

Posted by David Ross on Sun, Sep 15, 2019

Quick-WC-claim-resolution-300Filing a Workers’ Compensation Insurance claim is probably not one of your favorite things to do, but it’s essential when a worker is injured on the job. If you want to make sure the Workers’ Comp claim gets processed as quickly as possible - saving you both time and money - don’t annoy your adjuster.

Adjusters are busy too – juggling 150-200 claims every day - and would like to see your claims processed as quickly and smoothly as possible.  The best way to make that happen is to provide them with what they need in a timely manner to make their job easier and avoid annoying them.

Here are Four Things That Are Frequent Annoyances to Workers’ Compensation Adjusters:

Not completing the Injury Form Correctly

The first step in any WC claim is completing and submitting the injury form. All of the information on that form – social security number, birth date, type of injury, etc. - is relevant to the adjuster and helps them process the claim more quickly. If you leave a field blank, they have to interrupt what they’re doing to contact you for the information.

If you want your claim processed more quickly, gather the information in advance and fill in every field on the form accurately. Make sure names are spelled correctly, the date of the injury is correct, etc. This first report is vitally important, so double check everything before submitting it, and remember if you leave a field blank, someone else could fill it in with information you don’t like.

Not Reporting a Claim Right Away

As soon as an injury occurs, start the process of gathering information to submit the claim as quickly as possible. Submitting a claim days after an injury occurs could force an adjuster to rush through the process and make mistakes. The quicker you can get it in, the more thorough the adjuster’s investigation will be, which results in more accurate and ethical decisions regarding the claim without penalties, leakage, or delays.

Also, adjusters will prioritize claims that include lost wages, so let them know upfront if that applies to your claim. They understand that any delay in the claim is another day of potential wage loss. Providing this information up front allows them to determine if the claim is compensable and get your employee back to work on light-duty as quickly as possible, which helps keep your claim costs down.

Not Knowing the Details of the Injury

Immediately after an injury occurs, begin gathering facts and witness statements to understand exactly what happened. Send all the information you gather to the adjuster and be prepared to answer questions about the incident if they contact you.

Witness statements can be crucial in determining the validity of a claim, and adjusters will compare those statements with the employee’s recount of the incident. If they see any discrepancies, they will research further, which could prevent payment on a false claim; thereby, minimizing leakage and helping to keep your WC costs down.

Not Working With Them

Adjusters are experts regarding the compensability of WC claims. They have been trained and certified to make WC decisions, but you are the expert regarding your employees and the type of work they do. Your input is crucial to ensuring an accurate investigation.

When an adjuster emails or leaves you a voice mail with a question, reply as quickly as possible. Also send anything you receive related to the claim to your adjuster as quickly as possible including bills and medical information.

If you want to save time and money and help ensure your Workers’ Compensation claims are processed as quickly and accurately as possible, keep these four things that annoy WC adjusters in mind.

Want to Learn More About Saving on Workers’ Compensation Costs?

Although Workers’ Compensation Insurance is required for most businesses with employees, that doesn’t mean you can’t get more bang for your buck! Start saving by giving the Workers’ Comp experts at American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, PA Workers Compensation Insurance, workers comp costs, Commercial Insurance Reading PA

Masonry Contractors: How to lower Contractor and WC Costs

Posted by David Ross on Sun, Sep 01, 2019

masonry-construction-insurance-300Construction is one of the most hazardous occupations today, and masonry contractors are no exception. According to Masonry Magazine, masonry construction is one of the high-risk specialty trades with a nonfatal injury rate of 191.5 per 10,000 equivalent full-time workers.

Creating a safer work environment for those tradespeople helps you avoid OSHA fines, increase employee morale, keep workers on the job, and lower your Contractor Insurance and WC costs.

About the Work

Masonry is a physically demanding job, and masons often work in fast-paced environments. Lifting heavy materials and standing, kneeling, and bending for long periods of time can be strenuous on workers. Plus, masons often work outside where it can be muddy, dirty, and dusty.

Common hazards for masonry contractors include the Occupation Health and Safety’s (OSHA) top four causes of construction fatalities  – falls, struck by, caught in/between, and electrocutions, along with cuts, heat exhaustion, exposure to noxious chemical, lifting and moving heavy objects, and overexposure to dust.

Here are four of the most common hazards masonry contractors face and ways to minimize those hazards:

Slips, Trips, and Falls

According to the Centers for Disease Control and Prevention (CDC), 26% of nonfatal work injuries that result in days away from work are the result of slips, trips, and falls. Construction workers are at risk for fatal falls from height by more than seven times the rate of other industries, according to the National Safety Council.

Masons are often required to use ladders and scaffolding to complete their work, which adds to the risk of falling and injury or death. 

Here are five ladder safety tips to avoid falls:

  • Inspect ladders for defects before using
  • Place the ladder on a stable and level surface
  • Use three points of contact at all times (one hand and two feet/two hands and one foot)
  • Don’t lean, stretch, or make sudden moves while on a ladder
  • The proper angle for setting up a ladder is to place its base a quarter of the working length of the ladder from the wall or other vertical surface

Here are five scaffolding safety tips to avoid falls:

  • Scaffolding should be erected by someone who is properly trained and qualified
  • Inspect scaffolding before using
  • Use proper fall protection
  • Fully plank the equipment
  • Use guardrails

Electrocution

The CDC reports that there were 82 electrocutions or 0.8 electrocution fatalities per 100,000 full-time workers in 2015. To avoid electrocution, know the location of overhead and underground power lines to avoid accidental contact, inspect all tools including extension and power cords for damage before using, ensure that all electrical equipment is properly grounded or double insulated, and protect cords from foot traffic, forklifts, and other equipment.

Lifting Injuries

According to the U.S. Department of Labor, lifting heavy items is one of the leading causes of injury in the workplace, and this type of injury often takes a long time to heal. The main causes of these injuries are the weight of objects, awkward postures, high frequency and long-duration lifting, inadequate handholds, and environmental factors.

Here are five lifting safety tips:

  • Use mechanical means to move heavy materials such as forklifts whenever possible
  • When manually lifting a heavy object, place it close to your body at the “power zone” height – mid-thigh to mid chest
  • Bend at the knees, not the waist
  • Turn by moving the feet rather than twisting at the waist
  • Take regular breaks

Heat Illness

Masonry contractors can become ill or even die while working in extreme heat or humid conditions regardless of their age or physical condition.  To help prevent heat illness, OSHA recommends that employers provide workers with water, rest, and shade and monitor workers for signs of illness.

Implementing a culture of safety from the top to the bottom of your organization, providing safety training, enforcing safety processes, and providing proper equipment and PPE can help reduce the number of injuries on your worksite and improve your bottom line. 

Is Your Contractors Insurance Too High?

If you think your Contractors Insurance is too high, contact one of the experienced agents at the American Insuring Group at (800) 947-1270 or (610) 775-3848 or connect with us online. We specialize in both Contractors and WC insurance and will compare your insurance costs with several companies to ensure that you get the best price.

Tags: Workers Compensation Insurance, Construction Insurance, Contractor Insurance, workers comp costs, Contractor Safety Management

Do Safety Incentive Programs Lower Workers Comp Insurance Costs?

Posted by David Ross on Sun, Jul 28, 2019

Incentive-programs-save-WC-costs-300In an attempt to lower workers’ compensation insurance costs, some companies implement safety incentive programs. For example, everyone receives a $25 gift card if there are no injuries reported for thirty days. This type of incentive program is called a “results-based” program, and at least on paper, makes perfect sense.


According to one study, between 1991 and 2001, companies with a safety incentive program saw a 44.16% reduction in the mean lost-time workday injury rate.

Again, this makes perfect sense; a safer workplace means fewer injuries and lower WC costs, so a company with no reported injuries for thirty days is a safer workplace, right? Maybe. The biggest flaw found in a results-based incentive program is that it can encourage underreporting.

A 2010 survey conducted by the Government Accountability Office, found that approximately 75% of manufacturers in the US had safety incentive programs that could potentially affect workers’ reporting of injuries and illnesses.

Let’s say on day twenty Joe Smith incurs an injury, but he doesn’t want to blow the $25 gift card for all of his coworkers, so he decides (or is pressured by coworkers) to wait to report the incident. When he does finally report that injury ten days later, there could be complications resulting in a more severe injury and higher medical costs.

Plus, if the injury is caused by an unsafe situation, another employee could be injured before the initial injury is reported and the hazardous situation remedied. Either way, you’re looking at higher medical costs and higher workers’ compensation costs.

That doesn’t mean that safety incentive programs don’t work. They can motivate employees to pay attention to safety and to work more safely, but they have to be done correctly. If the incentive program focuses on the incentive and not actual safety, it can interfere with creating a safer work environment.

Here are six tips to help you create an effective safety incentive program to help lower your workers’ compensation costs:


An Incentive Program Has to Be Part of a Comprehensive Safety Program

Some companies try to create an incentive program without having a comprehensive safety program – including safety training, accident investigations, a return-to-work program, etc. - in place. An incentive program is a way to encourage employees to engage in a company’s safety program and safe actions that it creates. 

Consider “Process-Based” Incentives

As discussed earlier, a results-based incentive program can result in unreported injuries, which is not reducing accidents or injuries. Instead of rewarding employees for the number of days without an incident, try rewarding positive, proactive behavior such as attending safety meetings, wearing PPE, scoring well on a safety training quiz, or suggesting ways to create a safer workplace. 

Provide Genuine and Meaningful Incentives

You need to find out what motivates your employees, and you need to offer a meaningful incentive that is worth achieving. Not everyone is motivated by money. Some would rather be recognized for doing a good job.

Incentives can include a pizza party or exclusive T-shirts with the company logo or an annual recognition dinner where employees on every level mingle, and top management presents awards to employees who have practiced safe work practices.

Award Incentives Often and to Many Employees

Workplace safety is a year-round activity. If you only award employees once a year, it’s easy to forget about safety three or four months into a program. Instead, offer frequent rewards – quarterly, monthly, or even weekly.

Everybody wins when you offer a safe work environment, so your incentive programs should take that same approach and award everyone – from top management to individual employees and from employees who already work safely to those who need encouragement to work more safely.

Get Buy-In From Upper Management

Upper management is footing the bill, so they need to understand the goals of the program and how it will progress. It takes a while to see a decrease in injuries and the resulting lower WC costs. 

Plus, there is usually an upfront investment required for things like signs, results boards, and even time. As the program progresses and employees become more familiar with the program, those costs typically decrease.

But if upper management doesn’t see immediate results, they could withdraw their support if they don’t understand the process.

And in order to create a culture of safety, upper management needs to buy into your company’s safety program, including incentives.

KISS

Keep it Simple Stupid! Don’t make an incentive program so complicated that your employees don’t understand what they need to do in order to receive the award. If it’s too complicated, a safety incentive program could backfire by lowering employee morale.

Providing a safe working environment is every employer’s responsibility. The good news is that efforts to create a safer workplace – such as safety incentive programs – can also help improve your bottom-line.

Get the Best Price on Workers’ Comp insurance

The experienced independent agents at American Insuring Group are committed to getting you the very best price on quality workers’ compensation insurance protection. Give us a call at (800) 947-1270 or (610) 775-3848 or find us online.

Tags: workers comp insurance, workers comp costs, WC Insurance, Safety Programs

The Cost of Hearing Loss in Construction Workers

Posted by David Ross on Sun, Jun 23, 2019

construction-hearing-loss-cost-300Work-related hearing loss is costing construction companies millions of dollars in contractors’ insurance costs every year. 

If you own a construction company, the chances are good that your employees are exposed to a lot of noise – heavy equipment, jackhammers, etc., which can lead to hearing loss and have an impact on your contractors’ insurance costs. 

Hearing loss is the most common work-related injury. The Center for Disease Control and Prevention (CDC) reports that about 22 million workers in the U.S. are exposed to hazardous levels of noise every year. A 10-year-study of more than one million construction workers in the U.S. found the construction industry has the second highest number of employees affected by hearing loss. 

Work-related hearing loss is costing businesses an estimated $242 million in workers’ comp claims every year. Training your employees about hearing loss and ways to avoid it and enforcing safety measures can help not only lower your contractors’ insurance costs but also save your employees from permanent hearing loss. 

The Science Behind Hearing Loss

Hearing loss can occur as a result of exposure to loud noises, exposure to metals or solvents, or a result of physical trauma like a blow to the head. 

Studies show that regular exposure to sounds 85-90 decibels (dB) can cause hearing loss. A truck or motorcycle that is five yards away can emit sound at 90 dB, and a jackhammer that is three feet away can emit 120 dB. 

Approximately 9% of workers who were NOT subjected to noise levels above 90 decibels experience noise-induced hearing loss by age 50, but 60% of construction workers who were repeatedly exposed to noise at 120 dB did experience hearing loss by the age of 50. 

The National Institute of Occupational Safety and Health (NIOSH) recommends that all worker exposures to noise should be controlled below a level equivalent to 85 dBA for eight hours to minimize occupational noise-induced hearing loss. 

As an employer, you are required to take proper measures to protect your employees from hearing loss when workplace noises exceed those levels. 

Tips to Avoid Hearing Loss

Once an employee experiences noise-related hearing loss, it is usually permanent. The good news is that like most workplace accidents and diseases, hearing loss is preventable. 

If you want to save your employees’ hearing and reduce your WC costs, share the following tips with your employees:

  • Avoid Excessive Noise both on and off worksites
  • Wear industrial-grade hearing protection any time you are working at a noisy construction site.
  • Take regular breaks away from noisy areas
  • Work as far away from loud equipment as possible
  • Using headphones to listen to loud music to drown out a noisy work environment can do more harm than good. A better option is to use noise-canceling headphones, which can reduce your exposure to harmful noise levels both on and off the job.
  • Quit smoking because smoking suffocates the cells in your body, including those in your ears, which can increase your chance of experiencing hearing loss.
  • High blood sugar levels can damage cells in your body; thereby, causing hearing loss, so watch your blood sugar levels.
  • Never put anything including cotton swaps directly into your ears because you can injure your eardrum.
  • Schedule regular hearing tests 

Younger workers often feel impervious to workplace injuries including hearing loss, so it’s your responsibility as an employer to make your employees understand the prevalence of hearing loss among construction workers, what causes it, and how to avoid it, and you should require hearing loss protection protocol.  Eventually, they will thank you, and you will see immediate benefits in lower WC costs. 

Want to Learn More About Saving on Your Contractors’ Insurance?

Give one of the experienced agents at American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or connect with us online.

As independent agents and specialists in contractors’ insurance, we will compare the cost of your insurance with several companies to help ensure that you get the right coverage at the best price!

Tags: Construction Insurance, Contractor Insurance, workers comp costs, Contractor Safety Management

Lower Trucking Workers’ Comp Costs With Safety Training

Posted by David Ross on Sun, Jun 09, 2019

save-truck-workers-comp-300If you want to lower workers’ compensation insurance costs in your trucking company, the solution is simple! Provide safety training to lower the number of injuries, cultivate happier and more productive employees, and lower your WC costs. 

When it comes to safety training for truck drivers, it’s natural to think about steps to avoid traffic accidents. After all, the CDC (Centers for Disease Control and Prevention) reports that crashes are the leading cause of on-the-job deaths for truck drivers in the US. 

But truck drivers also incur injuries getting in and out of their trucks or handling cargo, and these injuries can affect your workers’ comp costs. The good news is that many common workplace injuries in the trucking industry are preventable with the right safety training. 

Here are four areas that should be included in any safety training in the trucking industry if you want to lower your workers’ comp costs

Slips, Trips, and Falls

According to the National Safety Council (NSC), 23,490 transportation and warehousing employees were injured in falls, and 46 died in 2016. The NSC also found that the fall doesn’t have to be from a high level to cause severe and sometimes fatal injuries.

Here are fall safety tips:

  • Ensure proper training on the use of all equipment
  • Never push or carry a load that will block your vision
  • Clean up spills immediately
  • Keep areas where employees will be walking free of clutter
  • Make sure all mats, rugs, and carpets lie flat
  • Wear slip resistant shoes
  • Check all equipment for damage before using 

Three-Point Contact

According to the Infrastructure Health and Safety Association, more than one-quarter of all injuries to equipment operators and truck drivers occur while getting into or out of equipment and trucks. One way to avoid these injuries is to employ the three-point contact rule. 

That means maintaining three points of contact with the truck – two hands and one foot or two feet and one hand - whenever climbing in or out of your vehicle. 

Lifting

Lifting is such an every-day activity that it’s easy to forget how quickly an injury can occur when improperly lifting cargo, but those injuries can significantly affect your workers’ compensation costs. According to the Occupational Safety and Health Administration (OSHA), lifting heavy objects is one of the leading causes of workplace injuries. Shoulder and back injuries accounted for 36 percent of injuries that resulted in missed work days, and the most significant factors in these injuries were overexertion and cumulative trauma. 

Training your employees on how to lift heavy items correctly can avoid back sprains, wrist and elbow injuries, muscle pulls, spinal injuries, and more. 

OSHA reports that five factors generally contribute to lifting injuries – the weight of the object being lifted, awkward postures, frequent or long-duration lifting, inadequate handholds, and environmental factors. 

Here are some tips from OSHA that address these common factors.

  • Use equipment such as forklifts and duct lifts to lift heavy items
  • Use your legs when lifting objects from a low location
  • Avoid twisting
  • Break down loads into smaller units
  • Rotate tasks, so workers aren’t doing the same activity too long
  • Work in teams
  • Take regular breaks
  • Move materials with inadequate (or no) handholds into containers with good handholds
  • Adjust work schedule to limit exposure to extreme heat or cold temperatures 

Falling Cargo

Loads can shift while in transit, making the simple task of opening a trailer door a potential risk. Improperly secured loads can cause serious injuries and increase your WC costs. 

Here are a few tips to avoid injuries caused by falling cargo:

  • Make sure the load is firmly immobilized or secured on your truck
  • Open one trailer door at a time and stand behind the door as you open it
  • Do not attempt to catch falling cargo 

Training in these four areas and creating a culture where safety is a priority and a work environment where workers feel comfortable reporting injuries will help reduce injuries and lower your workers’ comp insurance costs. 

Save on Workers’ Compensation and Truck Insurance!

To learn additional ways to save on workers compensation and other truck insurance costs, give one of the experienced agents at American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or connect with us online. As independent agents, we're free to compare the cost of insurance among lots of companies to ensure you get the best price on all your commercial insurance needs! 

Tags: Workers Compensation Insurance, truck insurance, workers comp costs, Trucking Insurance

Save on Workers Comp Insurance by Complying with OSHA

Posted by David Ross on Sun, Jun 02, 2019

lower-WC-insurance-costs-300.jpgAlthough it often seems as if the Occupational Safety and Health Act (OSHA) has a ridiculous number of rules and regulations for business owners, complying with those rules can help lower your workers compensation insurance premiums. 

OSHA’s intention is to protect employees from workplace injuries; therefore, following OSHA’s rules can help create a safer work environment for your employees, which results in fewer injuries and lower WC costs. Plus, not complying with OSHA’s regulations, can result in hefty fines. 

We’re here to help you better understand OSHA and its rules and regulations and to help your business comply with those rules and save on workers’ comp costs

About OSHA 

OSHA, established in 1971, is a government agency that is part of the US Department of Labor. Its primary purpose is “to assure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.” OSHA’s rules and regulations cover most private sector employers and their workers, along with some public sector workers. 

Since OSHA was established, workplace injuries, illnesses, and deaths have decreased significantly. “Although accurate statistics were not kept at the time, it is estimated that in 1970, around 14,000 workers were killed on the job. That number fell to approximately 4,340 in 2009,” according to OSHA. “At the same time, U.S. employment has almost doubled and now includes over 130 million workers at more than 7.2 million worksites. Since the passage of the OSH Act, the rate of reported serious workplace injuries and illnesses has declined from 11 per 100 workers in 1972 to 3.6 per 100 workers in 2009.” 

Fewer workplace injuries and illnesses not only lower commercial insurance premiums, but they also create healthier workplaces and happier employees. 

OSHA Employer Responsibilities

As an employer, it is your responsibility to provide a safe workplace that is free from OSHA-recognized hazards. Here are three ways to do that:

  • Use color codes, posters, labels, or signs to warn employees of potential hazards.
  • Establish and update operating procedures and safety training, and make sure your employees understand them.
  • Ensure that employees have safe tools and equipment that is properly maintained.

It is also your responsibility to follow OSHA requirements, which include the following:

  • Post the OSHA poster that informs employees of their rights and responsibilities in a prominent location.
  • Report all work-related injuries to the nearest OSHA office within eight hours.
  • Keep records of all work-related injuries and illnesses and ensure that employees and their representatives can easily obtain employee medical records.
  • Post and correct cited OSHA violations.

OSHA also encourages all employers to adopt an Injury and Illness Prevention Program. Click here to learn more about your OSHA responsibilities. 

Honoring your OSHA responsibilities and instituting safety programs will create a safer work environment, minimize injuries, and help lower your WC Insurance. 

Employee Complaints

There are two main types of complaints employees can file with OSHA against your company as his or her employer:

  • Safety and health complaint

    If an employee believes their work environment is unsafe or detrimental to their health, they can file a confidential report with OSHA requesting an inspection of their workplace.
  • Protection from retaliation complaint

    If an employee who submits a complaint to OSHA feels they have been retaliated against, they can file this type of complaint with OSHA. 

Your best defense against both of these complaints is to do your best to create a safe work environment, follow OSHA’s rules and regulations, and keep an open line of communication with your employees. 

OSHA Inspections 

OSHA can inspect your worksite for any number of reasons including a complaint from an employee; after a severe injury or illness; a referral of a hazard from another federal, state, or local agency, or individual; or if you’re in a high-hazard industry or have experienced a high rate of injuries. 

Typically, employers are not notified of an impending inspection in advance; however, understanding the process can take some of the stress out of the experience. 

  • Preparation

    Before conducting an inspection, OSHA compliance officers research the inspection history of the worksite.
  • Opening Conference

    The compliance officer will explain why OSHA selected the workplace for inspection and describe the scope of the review, walkaround procedures, employee representation, and employee interviews. Both the employer and employee can have a representative accompany the officer during the inspection.
  • Walkaround

    The compliance officer and the representatives will then walk through the portions of the workplace covered by the inspection, inspecting for OSHA violations and hazards that could lead to employee injury or illness.
  • Closing Conference

    After the walkaround, the compliance officer holds a closing conference with the employer and the employee representatives to discuss their findings.

Understanding OSHA’s rules and regulations can help keep your employees safer, reduce the chance of an inspection and potential fines, and reduce workers’ comp insurance costs. 

Start Saving on Workers Compensation Insurance Today

To learn how your business can save on workers’ compensation and all other commercial insurance costs, call our experienced independent agents at American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or connect with us online. 

Our independence allows us to compare coverage from competing insurance carriers, so you can be confident of receiving the best deal on the right protection for your business in Philadelphia, Reading, Allentown, and far beyond!

Tags: Workers Compensation Insurance, workers comp, workers comp costs, Commercial Insurance

How to Prevent Repeated Workers Comp Insurance Claims

Posted by David Ross on Sun, Mar 31, 2019

Prevent repeated workers comp insurance claimsYou often hear horror stories about fraudulent workers compensation insurance claims, but fortunately, most employees that make WC claims are honest, hard-working individuals.

Occasionally, you’ll run across an employee who seems to be a repeat WC claim offender. Some are legitimate claims, and some are not, but repeated WC claims can be annoying, time-consuming, and costly.

Here are steps you can take to determine if workers are trying to take advantage of the system, and ways to stop them from making repeated false claims or from incurring repeated injuries:

 

1 - Don’t Antagonize - Give Injured Employees the Benefit of the Doubt

Your first step is to remember that both you and the injured employee are human, and as humans, we all have emotions and make errors. Injured employees need to be treated with respect, or you may inadvertently antagonize the employee and make matters worse, or you may be dealing with a worker with a legitimate claim.

For example, an employee who is willing to do whatever it takes to get a job done may do things that increase their risk of injury. An employee may be naturally clumsy, or they may not be aware of the right way to get a job done safely.

If you encounter an employee who has multiple WC claims, you need to investigate it, so you know what steps to take to reduce the number of claims. It’s vital that you go into the investigation with an open mind. Start the investigation by giving the injured employee the benefit of the doubt until or unless you find a reason not to.

2 - Investigate the Injury

Investigations are essential with any WC claim but especially with an employee with repeated claims. Gather statements from the employee, supervisor, any witnesses, and the treating physician, so you can understand the extent of the injury and how the injury occurred. If you don’t think the treating physician is being honest or is not providing the best information or treatment, it’s okay to get a second opinion.

You also need to figure out the actual cause of the accident. A cause may seem obvious but upon a more in-depth inspection may prove to be a secondary cause – or not the cause at all. Review studies conducted on similar injuries; look at all potential factors; consider other factors such as previous injuries and comorbid conditions such as obesity, mental health issues, substance abuse, etc.; consider the validity of testimonies; and with all that information, make a conclusion.

3 - Talk to the Injured Worker

As mentioned earlier, injured workers are human and have emotions. Like everyone, some of those emotions are logical, and some are not. Having an open, non-confrontational conversation with the injured employee can reveal things such as personal challenges at home, psychosocial issues, or problems with a supervisor or with your company.

4 - Take Steps to Avoid Future Claims

Once you understand the reasons for the repeated WC claims – whether they’re legitimate or not – you can take steps to avoid future claims. If it turns out they don’t know how to perform their job safely, provide additional training and education. If you determine that they are physically unable to do their job effectively, consider transferring them to another job that they can perform safely.

However, if they’re trying to take advantage of the system, be respectful, but let them know that you will be watching them and will take appropriate action if abuse of the system is found, up to and including termination.

Protecting Your Bottom Line

Repeated workers’ compensation claims affect your bottom line while potentially harming productivity and employee morale.

You know what else affects your bottom line? Paying more than you need to for workers comp insurance!

To get a GREAT deal on your WC insurance, give the independent agents at American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or find us online. As independent agents, we’re free to shop and compare rates among competing insurance carriers to make sure that you are getting the best WC insurance at the best possible price!

Call or click today to get started.

Tags: Workers Compensation Insurance, workers comp costs, Workers Compensation Insurance Fraud

Warning Signs of Workers Comp Insurance Fraud

Posted by David Ross on Sun, Mar 10, 2019

Use these warning signs to reduce the risk of workers comp insurance fraud, and then save on WC insurance in Philadelphia, Reading, Allentown, Lancaster, Pittsburgh, Erie, PA and elsewhere.The majority of employees are honest, and the majority of workers compensation insurance claims are legitimate.

Unfortunately, there is a small group of people who commit workers compensation fraud, and they cost companies billions of dollars every year in rising insurance premiums, production delays, and training costs. 


What is EMPLOYEE Workers Comp Insurance Fraud?

Workers Compensation fraud occurs when a WC claim is filed that is not entirely truthful to get money or extended time off. Fraudulent claims include faking or exaggerating an injury, claiming an injury that occurred off the job, or claiming an old injury that didn’t heal.

Workers comp fraud is a serious crime, and one of the fastest growing types of insurance fraud in the U.S. Estimates place the cost of WC fraud to companies at $6 to $7 billion every year.

The good news is that there are steps you can take to minimize WC fraud by both employees and providers.

One of the first steps is to recognize common warning signs.

 

13 Warning Signs of EMPLOYEE Workers Comp Fraud

Protect your business from WC insurance fraud by recognizing the warning signs of fraudulent claims:

  1. No witnesses
  2. An injured employee refusing treatment
  3. Delayed reporting of injury
  4. Conflicting or inconsistent report of the incident
  5. An employee with a history of making WC claims
  6. An employee with a history of frequently changing addresses, jobs, or physicians
  7. Suspicious medical providers or legal consultants
  8. An injury that occurs just before or after a weekend or holiday
  9. An injury that occurs right before or after job termination, layoff, end of seasonal work, a strike, or the end of a project
  10. An injured employee working a side job
  11. An injured employee doing activities that would not be possible with the claimed injury
  12. An injured employee who is difficult to get in touch with
  13. An injured employee who hires an attorney and tries to get a quick settlement

Never accuse an employee of fraud. If you see two or more of these warning signs, notify your insurance company immediately, but remember these are just potential signs that there could be an issue. It doesn’t mean that every workplace injury that occurs with no witnesses is fraudulent or that every injured employee who is hard to get in touch with is lying. They are just indicators that there may be a problem. 

How to Minimize Employee WC Fraud

  • Follow a screening process for all new employees by conducting thorough background checks of all applicants, contacting references, and watching for red flags such as a spotty work record or a criminal record
  • Create clear WC policies and establish a zero-tolerance policy on WC fraud
  • Clearly communicate these policies with new hires and provide WC fraud training
  • Create a culture of safety to reduce opportunities for fraudulent claims
  • Install video surveillance
  • Consider establishing ways that employees can report suspicious or fraudulent claims anonymously
  • If you suspect fraud, notify your insurance carrier immediately and provide supporting documentation.



What is PROVIDER Workers Comp Insurance Fraud?

Unfortunately, it isn’t just employees who commit WC fraud; providers of WC benefits such as medical and legal professionals sometimes take advantage of WC programs with unnecessary billing, fake clinics, kickback schemes, and inflated worker injuries or service costs

8 Warning Signs of Provider WC Fraud

  1. Billing for services never received
  2. Billing for equipment never used
  3. Billing for treatment that was never performed
  4. Duplicate billing
  5. Higher than usual bills for services performed
  6. Billing for procedures that don’t make sense for the reported injury
  7. Increasing visits
  8. Ongoing medical services that don’t improve injury

WC fraud can cause a ripple effect that touches everyone. Fraudulent claims create additional costs for insurance companies, which can turn into higher insurance premiums for employers. Increasing business costs can cause an increase in prices customers pay, a decrease in employee benefits, or even job cuts.

 

How to Get a Great Deal on Workers Comp Insurance

Our Trusted Choice independent workers comp insurance agents will help you save on the best workers comp insurance for your business. Call today.To learn more about preventing and recognizing WC Fraud and ways to save on Workers’ Compensation Insurance, contact the WC specialists at American Insuring Group at (800) 947-1270 or (610) 775-3848 or find us online.

Our Trusted Choice independent agents will work hard to analyze and compare plans from competing WC insurance carriers, so you’ll get the best price on quality protection.

Call or click today to get started!

Tags: Workers Compensation Insurance, workers comp costs, Commercial Insurance, Workers Compensation Insurance Fraud

Save on Workers Comp Insurance Without Losing Protection

Posted by David Ross on Sun, Feb 10, 2019

Use these tips to save on PA workers comp insurance without losing valuable protection in Philadelphia, Pittsburgh, Allentown, Harrisburg, Reading, Lehigh Valley and more.In Pennsylvania, most employers are required by law to have Workers Compensation (WC) insurance. According to the Department of Labor & Industry, “Employers who do not have workers' compensation coverage may be subject to lawsuits by employees and to criminal prosecution by the Commonwealth.”

Workers compensation insurance is designed to protect both employees and employers. If an employee is injured on the job, WC helps pay for medical costs and lost wages. If an injured employee sues their employer, WC helps pay for legal fees and any resulting financial settlements.

The good news is that there are steps you can take to lower your WC premiums without losing the protection that it provides. 

How is Your Workers Comp Insurance Premium Calculated?

There is a simple formula that determines how much you pay for WC. You can control some things within that formula, and others you can’t, so it’s important to understand the formula before you can understand how to lower your premium costs. Let’s take a look at the formula and break it down.

RATE X (PAYROLL/100) X EXPERIENCE MODIFIER = Premium

RATE

This is one of the parts of the formula that you have little control over. The RATE for each employee is based on his or her classification code. An employee’s WC classification is determined by what duties the employee performs or “the scope of work performed” and how dangerous his or her job is along with what state they work in. There are over 700 different classification codes.

If an employee is a tree trimmer, their classification code is 106 with a rate of $22.91 in Pennsylvania. An employee with a job that isn’t as hazardous and where he is less likely to incur an injury, such as a clerical office employee (classification code 8810) has a rate of $.34 in Pennsylvania. If you plug each of those numbers into the formula, you can see how different your premium rate will be.

The only thing you can do about the classification code is to make sure that every employee is classified correctly, so, for example, make sure that a clerical worker isn’t accidentally given a tree trimmer classification code. On the other hand, if you assign a clerical classification code to a tree trimmer, you could face a sizable additional premium at your year-end audit.

Assigning the correct classification code isn’t as easy as it sounds, and it’s where an experienced insurance agent who specializes in workers compensation is crucial.

PAYROLL

Your payroll is what it is, and there isn’t anything you can do about it in the WC premium calculation except to make sure that the projected payroll used in the formula is accurate. If you think it’s too high, don’t wait for an audit. Ask your insurer to adjust your payroll number.

EXPERIENCE MODIFIER

This is where you can really make a difference in your workers’ compensation insurance premiums. The experience modifier is a score your individual company receives based on your company’s loss history compared to the average for your industry.

A score of 1.00 is assigned if your loss history is average. If you’ve had a lot more injuries and WC claims than your industry average, your experience modifier will be higher than 1.00. If you have fewer injuries and claims, your score will be lower. 

Try plugging different numbers into that formula, and again, you can see just how much your experience modifier score can affect the cost of your premium. If you can lower your modifier, you can reduce your premiums. The best way to do that is to create a safer working environment for your employees, so there are fewer injuries and fewer claims. This is the reason that we focus so much on safety in this blog.

 

We Specialize in Workers Comp Insurance, so Contact Us for Help

Save-on-WC-Ins-Protection-150American Insuring Group specializes in Workers’ Compensation insurance, and our independent agents will make sure that you get the best possible price on quality workers comp insurance.

How? We diligently compare competing rates among many insurance carriers, and then come back to you with the best deal on the insurance that meets the unique needs of your business.

So call us today at (800) 947-1270 or (610) 775-3848 or connect with us online.

Tags: Workers Compensation Insurance, workers comp costs, Commercial Insurance

3 Workers Comp Insurance Claim Investigation Tips

Posted by David Ross on Sun, Jan 27, 2019

Follow these tips when investigating workers comp insurance claims in Philadelphia, Reading, Lancaster, Allentown, Pittsburgh, Erie, PA and beyond,Every workers compensation insurance claim should be investigated because it’s imperative to making accurate and legal assessments related to primary liability.

To do that, you need to know a bit about the law and about medicine to create an efficient workers compensation program.

Most business owners lack extensive knowledge of both medicine and the law, so here are 3 valuable tips to help you investigate Workers Compensation (WC) claims. 

1 - First Report of Injury 

This document is the beginning of any WC insurance claim investigation, and it serves as the basis for your insurance company’s investigation making it a critical document to any successful resolution of a WC claim.

The form you use may be issued by your state’s industrial commission or could be company-specific. Whichever type of form you’re using, the information on it needs to be accurate and complete. This is an instance when you do want to sweat the small stuff.

Before submitting this form, make sure it is completely filled out and that the information is correct. Check that the name of the injured employee is spelled correctly; that you have the correct social security number, date of injury, and wage info; and any potential witnesses are listed.

Make sure information about the injury is complete and accurate including when, where, and how the injury occurred, type of injury, the body part affected, and where the injured employee received medical care and treatment.

You should also know who completed the form and even a little background about that person. It’s a balancing act; you need to trust but at the same time verify that all the information is correct.

Often, the space allowed is not enough to provide thorough information, so don’t be afraid to write “see attached” if you need more room to describe the accident including alternate explanations of what did or didn’t occur.

2 - Recorded Statements from Injured Employee and Witnesses

First, make sure you understand the laws in your state regarding recorded statements and that you follow those guidelines. Then you want to obtain as much detail as possible. You should ask questions about:

  • The claimant’s background information such as date of birth, education, work history, etc.
  • The claimant’s prior medical history including surgical history, car accidents, chemical and substance abuse treatment, mental health, etc.
  • Potential interveners such as public assistance, veterans' benefits, unemployment compensation and history, etc.
  • Working environment at the time of the injury such as the claimant’s manager or supervisor, work duties, wage history, verbal and written reprimands, etc.
  • Detailed information about the injury such as a description of injury, immediate injury symptoms, post-injury symptoms, etc.

To help avoid questions regarding the admissibility of the recordings, make sure that the employee reviews and signs a transcribed copy of the statement.

3 – WC Documentation

There are several documents available to you as you delve into a workers’ compensation claim investigation including the following:

  • Medical records and authorizations to discover prior injuries or conditions.
  • Industrial Commission records – Most states keep WC records on file with whatever state agency is responsible for overseeing the WC act. Although you will probably need to get authorization to obtain these records, they can contain a great deal of information about an employee’s prior medical history.
  • Central Index Bureau Records (CIB) or ISO report - Although these reports may not be admissible, they can provide information about prior insurance-related claims made by the injured employee that can lead to other information that is admissible

A thorough Workers Compensation claim investigation takes time and effort but can save you thousands of dollars and reduce your insurance costs. Follow these 3 tips to make the process go more smoothly and lead to quicker and more successful Workers Comp claim resolutions.

 

Save Big on Workers Compensation Insurance!

Contact us for all your PA workers compensation insurance needs.Workers comp insurance can be more affordable than you think!

To learn how you can save big on Workers Compensation Insurance, give the independent experts American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or contact us online.

Tags: Workers Compensation Insurance, workers comp costs, Commercial Insurance