On-the-Ball injury management lowers reserves and saves $$$


The insured is a new home construction contractor.


An employee suffered a laceration to his finger while using a saw. The carrier set the highest possible reserves for disfigurement, permanent loss of use, and temporary disability warranted for this type of injury.


Knowing that insurance company routinely set high reserves on claims and keep those reserves active until the claim is closed, the CWCA resolved to keep close tabs on every aspect of the claim. Along with skilled in-house claims specialists, the CWCA worked with the employer, medical providers and claims adjusters to continually assess the case and adjust reserves accordingly.


As soon as the employee was released to full duty, The CWCA asked the insurance carrier to remove any remaining reserve for disability. A short time later, the insurance company made a payment to the employee for scarring, and the CWCA requested they remove any remaining reserves for disfigurement. Later, the CWCA argued successfully to lower reserves for permanent loss of use.


By the Employer’s next valuation date, reserves on this claim had been lowered by more than $57,000. As a result, the client’s Mod rating was 19 points lower than it otherwise would have been. This meant a premium savings of more than $4,000.


You’ll receive important information to help you avoid overcharges on your workers’ compensation.