CLAIMS MANAGEMENT
Coordinating all aspects of a claim can be overwhelming but our team is here to expertly manage each part of the process in a timely and transparent fashion. The management of your claims is done by one of our dedicated claims adjusters. Our in-depth knowledge of NY State Workers’ Compensation law is one of the many reasons we are able to efficiently handle all of your claims needs.
Once a claim is reported we will manage everything from the initial investigation, 3 point contacts, determining compensability, setting appropriate reserves, litigation management and aggressively moving the file to closure.
Having a proactive claims management team simplifies the recovery process for injured employees and can expedite their return to work. From assisting with the scheduling of medical examinations to the recommendation of vocational rehabilitation services we provide valuable aid to your employees after an injury.
Claims Management Highlights
How are Fraudulent Claims Identified?
Multifaceted Fraud Investigation
We protect your company from false claims by providing comprehensive Fraud Investigation services. Our investigations include interviewing the injured employee, searching the ISO database for prior claims, in-person activity checks, surveillance, and web-based searches
Who Manages your claim reserves?
Swift provision of estimates of outstanding claim reserves
As part of our Best Practices Policy, SAFE, LLC assigns reserves to reflect the expected outcome of any claim based on a reasonable projection of future cost at any point in time. Reserves are reviewed and revised any time information is received to indicate a change of exposure. When changes are required they are documented and available for review.
What Reporting is Included?
Accurate preparation and timely submission of all claim related filings
The first way we save you money is by saving you time. Our claims management system can generate a variety of reports including but not limited to specialized loss runs, check registers, individual claim reports and accident trends.
We also handle the preparation and submission of all mandatory reports. Including all mandatory reports and forms required by the state Workers’ Compensation Board, IAIABC/Electronic Data Interchange and compliance with the Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007.
What About Recoveries?
Pursuit of recoveries under special funds or third parties
In addition to reducing your costs we also take responsibility for pursuing recoveries from third parties on your behalf. As part of our Best Practices Policy we recognize, document and pursue all potential sources for recovery immediately upon receipt of a claim or as soon as facts develop to indicate the possibility of a recovery. There is no additional charge for recovery, nor do we take a percentage of reimbursements received.
What if an injured employee retains an attorney?
Litigation Management
SAFE, LLC provides litigation management to reduce costs associated with litigation and hearings by maintaining open communication between the claim adjuster and appointed counsel.