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Opioids: The #1 Workers’ Compensation Problem

Posted by David Ross on Sun, Jun 16, 2019

Opioids are the biggest workers compensation insurance cost driverIf you want to keep your Workers’ Comp insurance costs down, you need to understand the effects of opioid abuse.

The economic burden of prescription opioid misuse in the U.S. is about $78.5 billion every year including healthcare, lost productivity, treatment, and criminal justice costs, according to the Centers for Disease Control and Prevention. Health insurers and workers’ compensation carriers bear about one-third of that cost, according to Claims Journal


The result is increased workers’ compensation costs. A 2012 report from Lockton Companies reported that “Prescription opioids are presently the number one workers’ compensation problem in terms of controlling the ultimate cost of indemnity losses. There has never been a more damaging impact on the cost of workers’ compensation claims from a single issue than the abuse of opioid prescriptions for the management of chronic pain.” 

Why is This Happening?

Often, when an employee is injured on the job, a physician will prescribe an opioid for the pain. The Addiction Center reported that in 2012, 259 million opioid painkiller prescriptions were written. According to the Talbot Campus, the US makes up just 5% of the world’s population but consumes about 80% of the world’s prescription opioid drugs. 

The problem is that opiates are one of the most addictive substances available today. The Addiction Center reported that of the 259 million prescriptions written in 2012, an estimated 2 million led to addiction. 

According to the Talbot Campus, prescription opioid drugs contribute to 40% of all US opioid overdose deaths. The National Institute on Drug Abuse reports that every day, more than 130 people in the US die after overdosing on opioids. 

Furthermore, approximately 5% of those who abuse prescription drugs eventually transition to heroin. 

The Link Between Prescription and Illicit Opioids

Opioids include pain relievers such as oxycodone, hydrocodone, codeine, morphine, etc. that are available by prescription. However, many opioid addicts turn to illegal drugs like heroin and synthetic opioids such as fentanyl.  The Talbot Campus reported that about three out of four heroin users misused prescription opioids before their use of heroin. 

Fentanyl, a synthetic opioid that is fifty times more potent than heroin, is cheaper to produce and more readily available than heroin. Pharmaceutical fentanyl is primarily used to manage severe pain for cancer patients and end-of-life palliative care. Non-pharmaceutical fentanyl is often mixed with heroin or cocaine – often without the users’ knowledge. 

According to the CDC, there were more deaths involving synthetic opioids (more than 28,000) than from any other type of opioid in 2017. The introduction of fentanyl and other synthetic opioids is currently the most significant concern among opioid experts.

What can you do as an Employer?

Despite these frightening statistics, most people who are prescribed opioids do not become addicts; however, the ones who do are costing U.S. businesses like yours billions of dollars every year.

Thankfully, some precautions can be taken to address pain relief for injured employees. Here are a few steps to take if you want to reduce your workers’ compensation insurance costs.

Educate Your Employees

Make sure they understand the risks of opioid use, how addictive it can be, and how to prevent problems.

Build Good Relationships with Providers

Build a good relationship with area physicians - especially physicians within your network – and pharmacy benefit managers to make sure that they understand the risks of opioid use and how to minimize those risks such as screening patients for addiction, avoiding the use of opioids as the first line of therapy, and conducting urine screenings.

Intervene

If you suspect a case of opioid over prescription or abuse, intervene by talking to another physician, the insurer, and/or the third-party administrator. 

Accidents do happen, and employees do get hurt, but don’t allow the prevalence of opioid addiction exacerbate the effects of those injuries on the injured employee, his or her family and coworkers, or your workers’ comp costs.

 

Want to Lower Your Workers’ Compensation Insurance Costs?

Another way to save on workers’ compensation and other commercial insurance costs is to work with an independent agent who can compare the cost of your insurance with more than one company.

Give American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or connect with us online. Our independent agents will make sure that you get the best price on quality insurance protection. 

Tags: Workers Compensation Insurance, PA Workers Compensation Insurance, Commercial Insurance, Opioid Epidemic

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

Opioid Addiction Dangers for Construction Workers

Posted by David Ross on Sun, May 19, 2019

Opioid addiction dangers for the construction industry and impact on workers comp insurance costsIt’s difficult to pick up a newspaper these days and not see an article about the opioid epidemic plaguing Americans.

It is a serious issue that is costing businesses millions of dollars every year.

According to the Center for Disease Control (CDC), more than 700,000 people died from a drug overdose from 1999 to 2017, and about 68% of the deaths that occurred in 2017 involved an opioid. The number of deaths caused by opioid overdose – both prescription and illegal – was six times higher than in 1999.

Impact on the Construction Industry 

The construction industry is not immune to this epidemic – in fact, it is hit harder than most. The very nature of the industry makes construction workers more vulnerable to opioid abuse than workers in other occupations. In 2016, 73% of injured construction workerswere prescribed a narcotic painkiller. According to the Substance Abuse and Mental Health Services Administration, construction workers suffer from substance use disorders at nearly twice the rate of the general population.

7 x More Likely to Die from Opioids?

One study found that construction workers in Ohio were seven times more likely to die from an overdose of opioids than workers in other professions. Another study found that construction workers in Barnstable County in Massachusetts accounted for 25% of all fatal overdoses from the prescription painkillers heroin and fentanyl.  

Higher Workers Comp Insurance Costs

This creates higher workers compensation (WC) losses, and WC insurance costs for construction employees are more than double the average cost for other occupations, according to the Center for Construction Research and Training. Narcotics such as opioids account for 29 percent of prescription costs in workers compensation, according to the National Institute for Occupational Safety and Health(NIOSH).

Why is Opioid Addiction Hitting the Construction Industry so Hard?

If you think about it, it is not a surprise that employees in the construction industry have been hit hard by the opioid epidemic. Here’s why:

  • Construction is a dangerous job prone to injuries like sprains, ligament tears, and pulled muscles, which leads to pain and the prescription of opioids to ease the pain.

  • The average age of construction workers in the U.S. is 41. In Pennsylvania, it’s 44. As we age, our bodies don’t heal as quickly as they did when we were in our 20’s.

  • Most construction workers don’t get paid if they don’t work, so many are willing to do what they need to work through the pain.

  • People in their late 30s and early 40s often have families to support, which means they need to work – whether they’re in pain or not. Medication can help ease the pain and allow them to continue to work and to support their families.

  • NIOSH found that adults over the age of 40 are more likely to use prescription opioids than adults 20 to 39.

  • Repeated opioid usage creates a cycle of abuse. In other words, when an employee is injured he or she may change their gait or how they carry materials, which can lead to a second injury. Research shows that a worker who has pain in three or more areas is more likely to become addicted to painkillers.

  • Prescription opioids are often readily available on construction worksites and shared among workers.

  • The stigma around addiction makes it difficult for workers to admit there is a problem

What Can You do as an Employer?

You can help minimize opioid addiction among your workers: 

  • Improve worksite safety to minimize injuries and the need for opioids.

  • Pay attention to your workers’ compensation medical provider network. Some networks limit opioid refills or prohibit physicians from dispensing narcotics leaving that to pharmacists. Some networks control how prescription drugs are reduced.

  • Educate your employees about how opioids work, their potency, drug interactions, and how they can become addictive.

  • Recognize the signs of addiction such as multiple injuries, doctor shopping, or physicians dispensing medications.

  • Provide a strong return-to-work program for injured employees, so they can return to work without provoking another injury.

  • Provide emotional support to injured employees.

  • Let your employees know treatment options such as counseling and pharmaceutical treatment.

The Human Toll

The human cost of this epidemic is astounding, but the financial loss to construction companies is also a concern. In an industry where workers’ compensation costs are already higher than average, adding in the problems associated with opioid addiction can put a real strain on your bottom line.

 

Cut Your Workers Comp and Contractor Insurance Cost – Contact Us Today!

Want to learn more about saving on your insurance costs? Give American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or contact us online.

We specialize in construction and contractor insurance and are aware of the unique challenges you face, including the cost of workers compensation insurance. We'll help you save a bundle while obtaining the quality coverage you need to be well protected!

Tags: Workers Compensation Insurance, Construction Insurance, Contractor Insurance, Opioid Epidemic

How to Handle a Catastrophic Workers Compensation Claim

Posted by David Ross on Sun, May 12, 2019

How to handle a major workers compensation insurance claim in Philadelphia, Pittsburgh, Erie, PA and elsewhere.It’s vital that any worker injury and subsequent workers compensation insurance claim is handled with care to ensure the well-being of the worker and the business. When it comes to more severe injuries and catastrophic claims, the stakes are even higher.

A catastrophic workers comp claim that is mishandled could end up costing millions of dollars. Proper handling ensures the best outcome for the injured employee and his or her family, the employer, and the payers.

The employer’s first step is to ensure that the injured employee receives the right treatment as quickly as possible. There should be a plan in place to handle any workplace injury including catastrophic injuries. The welfare of the injured employee should be paramount at this point.

3 Things to Keep in Mind:

1 - Show Compassion and Build Trust

Any injury can be scary for an injured employee and their family, but a catastrophic injury carries with it many additional fears and stress factors. The injured employee will likely have thoughts about whether or not they’ll be able to work again, how they’ll support their family, and how will the injury affect the rest of their life.

Meanwhile, in addition to worrying about their injured loved one, family members are likely thinking about how they’re going to pay the medical bills, take care of the injured person when they get home, and how they are going to juggle everything – work, kids, etc.

Someone from the company should visit the injured employee in the hospital. This provides a chance to express concern, get and give information, ensure the employee and family understand the process, get a feel for the employee’s attitude, and discover the extent of the injury and the prognosis.

Try to put yourself in their shoes and understand what they might be going through. It’s essential that you show that you care and that you try to build trust with the employee and his or her family. If you want to have the best outcome and help prevent litigation, show them that you are not the enemy, but that you are working with them toward the same goals.

2 - Determine the Cause of the Accident

It’s always vital to determine the cause of an injury, especially in a severe injury. Did a machine malfunction? Was it a lack of training? Is it a guarding issue? The answer to this question will help determine how the claim is handled.

For example, if the injury was caused by a machine malfunctioning, the employer may seek money through subrogation – pursuing a third-party that caused an insurance loss.

3 - Thoroughly Investigate the Injury

The only way to determine a cause is with a thorough investigation that determines what happened, how, when, where, and why. That includes talking to the injured employee, taking witness statements, reviewing video, and examining the site where the injury occurred.

In the case of a catastrophic workers compensation insurance claim, it’s a good idea to think of the site of the injury as a crime scene. Although crime may not have been committed, it’s essential to preserve the scene to help determine the cause.

All evidence surrounding the accident should be preserved until the investigation is complete. That means roping off the area and keeping employees away. Also, regardless of how gruesome the scene may be, do not attempt to clean it up until the claims adjusters and any other professionals have a chance to examine the area.

The claims adjuster will need to bring in additional experts such as a nurse case manager, medical advisor(s), safety experts, and home health experts.

Bottom Line

Mishandling of any workers’ compensation claim is a problem, and those problems are magnified when it comes to catastrophic claims.

 

Do You Have the Right Workers Comp Insurance Protection?

To learn more about workers compensation insurance, and to make sure you are properly covered, give the experienced independent agents at the American Insuring Group a call at (800) 947-1270 or (610) 775-3848 or find us online. We’ll make sure you’re properly covered, AND we’ll help you get a great price too!

Tags: Workers Compensation Insurance, 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

Prevent Struck-By Hazards and Save on Contractor Insurance

Posted by David Ross on Sun, Feb 17, 2019

Save on Contractor Insurance by preventing these struck-by hazardsA few weeks ago we began discussing the Occupational Safety and Health Administration’s (OSHA) Fatal Four. These are four safety hazards that account for the majority of all construction worker deaths.

Understanding how to recognize and prevent these hazards can save lives, improve employee morale, and help reduce your contractor insurance costs 

Again, the Fatal Four include the following hazards (statistics are from 2016).

  • Falls accounted for 38.7% of deaths
  • Being struck by an object accounted for 9.4%
  • Electrocutions accounted for 8.3%
  • Caught-in/between accounted for 7.3%

We covered caught-in/between hazardsand electrical hazardsin previous blogs. Today our focus is on the second highest cause of fatalities (9.4%) among construction workers – struck-by hazards.

What are Struck-By Hazards?

There are a lot of moving parts at a construction site and many hazards that can cause struck-by injuries. When a worker comes into forcible contact with an object that is flying, falling, swinging, or rolling, a struck-by injury can occur.

The four most common causes of struck-by hazards in the construction industry are flying objects, falling objects, swinging objects, and rolling objects.

Prevention:

Your first line of defense against this type of injury is being aware of your surroundings and using hard hats and personal protective equipment (PPE).

Hard hats should be worn on job sites at all times. They should be properly adjusted to sit firmly and securely on the head, and they should be inspected regularly for cracks, gouges, dents, and other damage. Exposure to sunlight and cleaning solvents can damage or weaken a hard hat, so they should be cleaned with mild soap and stored out of direct sunlight. 

If a hard hat is damaged or worn out, replace it immediately. It’s much cheaper to replace a hard hat than it is an employee.

Employees should also be equipped with additional PPE where appropriate. PPE that can protect against struck-by injuries may include safety glasses, face shields, and steel-toed boots. All PPE should meet American National Standards Institute standardsand all should be inspected regularly and replaced when damaged or worn out.

Here are preventative measures for each of the most common types of struck-by hazards.

Stuck-by Hazard 1: Flying Objects

Nail gun discharge accidents are the most common cause of flying-object injuries. However, thrown debris or tools, a tip flying off a saw blade, or any other object that is flying around the work site can also cause injuries.

Prevention:

Employees should stay clear of the line of sight when a nail gun is being used. And because nail guns create enough force to penetrate plywood and sheetrock, employees should also be aware if a nail gun is being used in an adjacent room. Check out “Nail gun Safety and Workers Compensation” for more information about nail gun safety.

Additional safety measures include regular inspection of all power tools, the use of protective guards, and wearing safety glasses, face shields, or goggles when working with power tools.

Stuck-by Hazard 2: Falling Objects

This type of injury can be caused by falling tools or materials falling off edges or suspended from a crane.

Prevention:

Areas, where work is being performed overhead, should be cordoned off, so employees avoid those areas. Employees who are working overhead should use toeboards, screens, debris nets, and catch platforms to keep tools and materials from falling 

Employees should also be aware of suspended loads and never walk or position themselves under those loads.

Stuck-by Hazard 3: Swinging Objects

Sometimes materials that are being mechanically lifted can begin to sway and can strike a nearby worker.

Prevention:

Employees should be aware when a load is being moved and avoid the swing radius of that load. Workers should also make sure they aren’t in a blind-spot of the heavy equipment operator.

Stuck-by Hazard 4: Rolling Objects

Moving vehicles or heavy equipment usually causes this type of injury, but it can also be caused by objects that roll, move, or slide into an employee.

Prevention:     

First, heavy equipment operators should be adequately trained in how to operate the machinery safely. Second, other employees should be aware of where heavy equipment is being operated and understand where the operators have limited or no visibility.

Contact Us and Get Ready to Save on Contractor Insurance!

These preventative measures can significantly reduce worksite injuries and death, which can lead to lower contractors’ insurance premiums. Another way to lower your contractor insurance costs is to contact American Insuring Group at (800) 947-1270 or (610) 775-3848 or connect with us online. 

As independent agents, we always compare the cost of your construction insurance among competing insurance companies to make sure that you’re getting the right coverage at the very best price!

Tags: Workers Compensation Insurance, Construction Insurance, Contractor Insurance, Commercial Insurance

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