Fundamental Pre-Injury Initiatives: Prevention and Preparation

Build an integrated safety and wellness program to avoid injuries and illnesses. Take a holistic approach and adopt communication programs that provide awareness and training on prevention at home, and at work.
Create a company-specific claim management workflow and procedures on what to do when an injury occurs.
Identify quality medical providers and establish relationships. Give the medical providers tools to assist them in developing a productive return-to-work plan.
Explore options for a) Injury Prevention, such as ergonomic evaluations and education; b) Early Medical Intervention, such as RN triage to determine if the incident is best cared for by self-care, clinic or hospital; and c) On-Site Medical Treatment, including first aid and physical therapy.

Fundamental Post-Injury Initiatives

Track claims to identify loss trends and make improvements to safety programs aimed at reducing these injuries.
Immediately report all injuries and stay in communication with the adjuster throughout the life of the claim.
Investigate accidents to determine the cause(s) of injury and implement plans to abate exposure.
Keep in touch with the injured worker, address any questions s/he may have, and create a mutually agreed-upon return-to-work plan with the physician, employee and employer.
Conduct regular claim reviews, with a focus on achieving the best outcome and closure. Request participation from all parties, including legal counsel, case manager and investigator, to see how each party can affect the outcome.

In California, SB 863 has attempted to address many components that today hinder best claim outcomes and increase claim costs. However, it will take time to fully implement these changes and to weigh the benefits to employers, employees and carriers. In the meantime, the best advice is to build your own best practices with the right claims-management partners.

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Analysis: Best Practices for Monitoring Property, Casualty and WC Claims

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