Risk ManagementWorkers Comp Projects

Christian DeVoll, Risk Management SpecialistDecember 2012

Project OverviewConducted 3 separate projects ($10,000 per project)

Looked at both State and Self Insured programs

7 properties participated: Ben Franklin, Clallam, Link, Pierce, Gray Harbor, Spokane, and Island Transit

3-4 months per project

Scope of WorkState Programs

Review open time loss claimsTrain personnel in investigating new claimsRevise plans for time loss claimsWork with transits to develop action plans

for remediating claims

Scope of Work (cont.)

Work with transits to develop benchmarks

Provide continuing support for both open and potential future claims

Scope of WorkSelf Insured

Reviewed systems used with TPA and agency’s request for improvement

Reviewed 2-4 open claims to determine level of TPA participation in claims

Review TPA contract for scope of work, deliverables, costs and extra fees

Scope of WorkSelf Insured

Reviewed type of loss control and claims data supplied by TPA

Reviewed documents to determine level of regular review of claims by TPA with agency

Program Benefits

On average 50% reduction in active open claims

Cost savings per open and future claims???

Increased effectiveness in claims processing

Professional services post project

Program Benefits (Cont.)Dispelling of Myth informationBetter understanding of the workers comp process and employers role

Better control of costs and ways to reduce themLight Duty programPeriodic follow of claims

Satisfaction Survey (State) I believe that I have been taught the appropriate skills by

the consultant so I can request actions an adjustor should take in resolving a claim

After working with the consultant, I feel confident I can advocate for what should be done on a claim with regards to managing the medical outcomes for a claimant so they can reach maximum medical improvement (MMI)

I believe after working with the consultant, we have been able to resolve/and or close claims in a more timely manner

Satisfaction Survey (State)

After working with the consultant, I know how to go about investigating a new claim and relaying that information to the Department of Labor and Industries adjuster.

I believe this type of consulting work should continue and I would use the service again, if offered.

Satisfaction Survey Self InsuredThe consultant gave us specific and helpful advice regarding our Request for Proposal for worker’s comp third party servicesThe consultant worked with us to help identify specific information regarding losses, causes of injury, and how to document that information for managers within our organization.The consultant reviewed a sample of our current claims and provided feedback as to the quality of adjudication services we were obtaining form our TPA. I believe this type of consulting work was helpful an I would use the service again, if offered.

Conclusions

Determining quantitative cost savings from Workers Comp project is difficult

Qualitative benefits include access to professional expertise, networking, and training

State costs of workers comp claims continues to escalate. Without some stop measure or quality control on workers comp, claims cost will become more burdensome for transit systems to absorb

Questions