Three Steps To Manage Costs After An Employee Injury

John Harp, CSP, ARM Mitsui Sumitomo Insurance Group

When an injury is reported to have happened to one of your employees, the actions taken by you as the employer can greatly assist your workers compensation carrier to reduce the workers compensation claim costs.

The initial information that you provide your insurance carrier can aid them in determining whether the injury was in fact caused by work. Information about how the injury occurred can assist you and the insurance carrier in evaluating and developing possible safety measures to prevent claims in the future. Your early actions also ensure the employee receives prompt and proper medical care and reduces the likelihood of the employee retaining an attorney, resulting in overall lower claim costs.

Injuries to employees can be a significant cost to your business. Preventing injuries to employees or customers is the first objective, but if an employee injury occurs, there are three key steps that can help reduce claims costs, prevent lawsuits and minimize disruption to the store’s operations.

Cost control and effective injury management occurs by: prompt reporting of claims, using network medical providers or occupational clinics, and having a plan for the employee to return to work.

Prompt Reporting
Did you know the amount of time between the date of an injury and the date it is reported to the insurance company has a direct impact on the cost of a claim? There can be different reasons for a delay on the part of the owner or employee. Have you ever heard or thought “I didn’t think it was a big deal” or “I thought the injury was minor and would get better on its own?”

Why prompt reporting matters:
• Research shows that claims reported within three days have a reduced total claim cost (see graph).
• Quicker access to medical care for the injured employee.
• Easier for the insurance adjuster to determine if the claim is compensable.
• Employee lost time or restricted activity can be reduced. The consequences of late reporting:
• Timely and thorough investigation of the claim is jeopardized.
• The employee may feel the owner does not care.
• There is an increased risk of legal action from the injured employee.
• Medical outcomes may be hindered through a delay in treatment.

How to achieve the best results:
• Remind employees that all injuries must be reported no matter how minor. The information should be documented to retain the facts and help in the claims handling process. If medical treatment is not needed, that’s okay. It’s important to document the facts in case a claim is filed later. (In the event of an assault, contact MSIG or your insurance company regardless of injury and call OSHA if there is hospitalization or a fatality.)
• Know who to call before a claim occurs and remind your managers about the accident reporting procedures.
• Stay involved in the claims process—keep in contact with your employee and claims adjuster.

Utilize Network Medical Providers Or Occupational Clinics
Medical costs represent almost 60 percent of workers compensation claims costs. Savings can be realized when negotiated medical costs (including prescriptions) are obtained through preferred or managed providers, or occupational clinics. These providers can provide quality care, understand workplace injuries and support early return to work efforts.

Plan For Early Return To Work
An important element to controlling costs is through working with the employee’s doctor and your claims adjuster. Following the doctor’s advice on work restrictions, make every attempt to accommodate those restrictions. The benefits of returning your employee to work:
• Reduces the chances of the employee seeking an attorney.
• Minimizes the overtime for other employees or disruption to work schedules.
• Employee retains fitness and improves their chance of a full recovery.

MSIG provides the workers compensation insurance for over 2,000 7-Eleven franchised stores throughout the U.S. through Aon, your insurance broker.

If you have workers compensation insurance provided by a different company, the same principles apply, but check with your agent for claims contact information and procedures.

The SEI Hotline is not the method to report injuries or claims to your insurance company. SEI should receive incident details, but your insurer needs the information to manage the claim and it’s a good practice to keep the contact information posted in the office.

By providing the three steps of prompt reporting of injuries, using preferred or occupational medical providers and supporting early return to work, you can have an impact on your workers compensation cost, thereby improving your bottom line. Learn more about these steps by contacting your agent/broker or:

John Harp, CSP, ARM
Risk Engineering Consultant | 908-604-2951

Greg Rice
Claims Account Executive | 513-719-8405