R&R Insurance Blog

Position Your Medical Provider as your Partner

Gone are the days of thinking of your medical provider as your enemy! Your medical provider can and should be a partner in your efforts to reduce your lost time claims and ultimately your premium

For more information please contact the knowledgebrokers

Medical Only vs. Lost Time Claims

Lost time claims have a significantly larger impact on your MOD and your WC premiums than medical only claims.

What does a $2,500 claim cost in premium?

Why the difference?

To find these answers and know more please contact a knowledgebroker

The Loss Control Visit

It is time for your renewal and a carrier loss control rep is about to pay a visit. The loss control visit is a time for you to sell your company to the underwriter. You have their attention. Here’s how to make sure your visit gets off to the right start.

For more information please contact your knowledgebroker

Remember – if your loss history is currently up and down as in our example, you can change that history and become more predictable.

Contact a knowledgebroker for more information

Saturday is a workday!

WAITING PERIOD TRAP:

The Waiting Period Trap is the black hole called Saturday! The WC Statute includes Saturday as a work day. It doesn’t matter if your business works Saturday or not. It is counted!

What does that mean? Saturday is counted as one of the days in the three day waiting period. If Saturday is the fourth day the employee missed work you then have a lost time claim.

Take Away # 3 discussed the impact that lost time claims have on your premium. These types of claims cost you 3 times as much in premium due to the impact on your experience modification.

Our takeaway #9 referred to the importance of the first conversation. Your first conversation to set the tone for delivering your policy is the only thing that could possibly keep you from experiencing the waiting period trap.

For more information please contact the knowledgebrokers

As a general rule, if an employee is terminated for cause, the obligation to pay workers compensation benefits continues. Similar to a layoff, or the employer’s inability to provide light duty work, a termination is viewed in much the same way. The injured worker is still considered to be restricted in the general labor market due to the injury, until he or she reaches maximum medical improvement, or is released to return to work without restrictions. *See Brakebush Brothers Inc. and Employers Insurance of Wausau vs LIRC 1997.

However, in recent years, the Wisconsin Department of Workforce Development has expanded their scope of potential situations where benefits may be suspended as the result of termination.

Here are a few exceptions:

1) The employee's employment with the employer has been suspended or terminated due to the employee's violation of the employer's policy concerning employee drug use during the period when the employee could return to a restricted type of work during the healing period. Compensation for temporary disability may be denied only if prior to the date of injury the employer's policy concerning employee drug use was established in writing and regularly enforced by the employer.

2) The employee's employment with the employer has been suspended or terminated due to the employee's alleged commission of a crime, the circumstances of which are substantially related to that employment, and the employee has been charged with the commission of that crime. If the employee is not found guilty of the crime, compensation for temporary disability shall be payable in full.

3) The employee has been convicted of a crime, is incarcerated, and is not available to return to a restricted type of work during the healing period.

The exceptions listed above all make good sense as it relates to benefit cessation. Without those exceptions, the employer’s insurance carrier is obligated to continue benefits. This also reduces or eliminates the circumstances whereby an employer terminates a worker simply to circumvent the payment of benefits.

For each Workers Compensation claim, an adjuster will open a file for the injured worker and set aside money specifically for the estimated cost of the claim.

Over the life of the file some money is spent and the remaining amount set aside is in "reserve". This reserve amount should represent the remaining cost of that claim.

Open Reserves
The dollars sitting in open reserves for your WC claims impact your Experience Modification. It is critical that these reserves be reviewed prior to the data being reported to the WC Rating Bureau.

If the actual cost of the claim will be less than the initial "estimated" cost, then the adjuster should lower the reserve. Lowering the reserve will help your Experience Modification.

When is the data reported?
Your WC carriers for the prior three years will report claim data to the WC Rating Bureau six months before your insurance renews. Open claim reserves should be verified prior to that date.

The Wisconsin State Supreme Court says a brake maker wasn't negligent in a machinist's death.

Walter Tatera, a former Hales Corners machine shop worker, died of cancer in 2004. His estate sued FMC Corp., a Milwaukee brake manufacturer, alleging disks the company sent to Tatera's shop contained asbestos and caused his cancer.

A Milwaukee judge found the company was not liable or negligent in Tatera's death. A state appeals court last year, however, ruled FMC could be sued for negligence.

The Supreme Court reversed that ruling in a 4-3 decision. The court says FMC's conduct didn't amount to affirmative negligence.

Jill Rakauski, an attorney for Tatera's estate, says she's disappointed and believes the estate should be allowed to make a claim.

Interstate Roofing has saved $1.3 million in premium since beginning their MOD management efforts with R&R Insurance.

“I can’t begin to explain what Jamie and R&R have done for us. In 2002 PLM had a mod factor of 1.15. We now boast a .69 mod. We have a fantastic safety program and a 45% reduction in premium. This reduction occurred during a huge company growth period.”
Grant Pozorski
Parking Lot Maintenance, Inc.