Moore: An Vital, Simple Process for Adjusters Has Disappeared| Employees Compensation Information

Of James Moore

Thursday, August 12, 2021 | 0

One task required for workers’ compensation claims seems to have disappeared over the years. Most adjusters can make their life a lot easier by completing this one task in advance.

James Moore

On the 13-point job compensation daily to-do list, this has to be the most important, aside from paying for the weekly benefits.

The simple task that only takes a few minutes is the three-point contact. In the 1980s and 1990s, not only was it necessary to establish contact within 24 hours (including Fridays), a recorded statement from the injured person was an additional additional task.

Some carriers and third-party administrators still require recorded statements. As always, and for all of the recommendations I’ve made, see your damage manual on how to deal with the three-point contact.

Contacting the treating doctor, employer and injured employee within 24 hours of receiving the first damage report (FROI) saves time and avoids headaches later.

Of course, if the employee is represented by a lawyer, the employee cannot be contacted, but the appraiser can call the law firm and at least speak to a paralegal or assistant. Some states do not allow contact with the doctor without the employee’s permission.

Most appraisers contact the employer and then send a letter to the employee and the doctor.

Claims files: the most important key

The adjuster is the communication hub of the file. Establishing three-point contact in all cases of damage seems to be an overwhelming task in the other daily tasks.

Establishing a working relationship with all three main parties to the file will make the case easier. The first three-point contact can help start the relationship.

As I write this, I am finding that Adjustment turnover remains very high during the pandemic. Sales create time pressure to accomplish this task.

The best way I recommend to contact you is by email as soon as the first “hello call” has been made within 24 hours. This makes file documentation much easier without having to enter a recording of a phone call.

My 3-3-3 contact recommendation keeps it short and sweet.

How do I get to the missing three-point contact? When reviewing workers’ compensation claims for agencies, freight forwarders, TPAs, lawyers, and state government agencies.

If you have any questions about how you can contact me 24 hours a day, you will know where to find me.

This blog post is provided by James Moore, AIC, MBA, ChFC, ARM and republished with permission from J&L Risk Management Consultants. Visit the full website at www.cutcompcosts.com.