AMAXX

FEBRUARY 17, 2025

A lack of clear communication often leads to confusion, frustration, and even litigation , increasing costs for both the employer and the injured worker. However, implementing strong communication strategies can significantly improve claim outcomes and reduce unnecessary legal battles. How do I get paid?”

Workers Comp 66

Workers Comp Claim Workers Compensation Injury 66

AMAXX

MARCH 10, 2025

Proper layoff planning isn’t just about handling employment transitions; it’s crucial for controlling claims costs and ensuring that resources are available to support genuinely injured workers. Timely processing prevents claims from becoming unnecessarily expensive and ensures each case receives the attention it deserves.

Workers Comp 59

Workers Comp Claim Workers Compensation Injury 59

AMAXX

MARCH 10, 2025

In the first part of our series, we emphasized the importance of thoughtful layoff planning to mitigate the risk of increased workers’ compensation claims following a workforce reduction or facility closure. Be meticulous in updating personnel files, health insurance documentation, and records of sick leave.

Workers Comp 59

Workers Comp Claim Workers Compensation Injury 59

AMAXX

MARCH 24, 2025

Click Link to Access Free PDF Download “Workers’ Comp Claims Review Checklist: 9 Must-Have, Serious-Impact Elements” A common and costly mistake employers make is overlooking allowable payroll deductions. You should consult with your insurance broker, attorney, or qualified professional.

Workers Comp 71

Workers Comp Premium Injury Workers Compensation 71

Insurance Journal

JANUARY 15, 2025

A recent decision and concurring opinion by a Florida appeals court may have upset years of practice and could raise costs for workers’ compensation insurers. Some claims that carriers were once ready to close out of due to the statute …

Workers Comp 264

Workers Comp Compensation Claim Workers Compensation 264

Insurance Journal

AUGUST 22, 2024

The West Virginia insurance commissioner’s office has adopted a new policy: It will soon begin destroying workers’ compensation claim files that are 10 years old or older. “Given increasing cybersecurity concerns and the type of information contained in the closed …

Workers Comp 279

Workers Comp Cyber Compensation Risk 279

Insurance Journal

OCTOBER 24, 2024

The owner of a Fresno, California-based for-profit vocational school was charged with engaging in fraudulent billing practices related to workers’ compensation. Paul Steve Ramirez, 59, was charged with 11 felony counts, including insurance fraud. The fraudulent insurance claims could reach …

Workers Comp 264

Workers Comp Compensation Insurance Claim Claim 264

Insurance Journal

AUGUST 29, 2024

Los Angeles area vocational school owner, Guillermo Frias, 65, of Paramount, and the school’s accounting manager, Yesid Colon, 54, of Baldwin Park, were arraigned following a California Department of Insurance investigation into allegations they submitted fraudulent claims to receive money …

Workers Comp 246

Workers Comp Claim Workers Compensation Insurance 246

AMAXX

MARCH 24, 2025

This post is one in a 3-part series: Part 1: Workers Comp Independent Premium Audits Explained Part 2: Workers Comp Independent Premium Audits Explained Part 3: Workers Comp Independent Premium Audits Explained To qualify for this treatment, construction employers must keep meticulous records specifying exact hours worked per classification code.

Workers Comp 59

Workers Comp Premium Workers Compensation Compensation 59

AMAXX

MARCH 11, 2025

Effectively managing workers compensation requires careful oversight and proactive measures to identify and prevent fraudulent or exaggerated claims. Surveillance serves as a powerful tool in validating claims, protecting your organizations financial health, and ensuring resources are dedicated to genuinely injured employees.

Workers Comp 52

Workers Comp Claim Workers Compensation Injury 52

AMAXX

MARCH 18, 2025

Many companies operate under an unwritten rule: accept every workers compensation claim, no questions asked. A well-managed workers compensation program should pay 100% of legitimate claimsand 0% of the claims that arent. Employees come to believe that every claim will be accepted, regardless of the circumstances.

Workers Compensation 71

Workers Compensation Compensation Claim Workers Comp 71

AMAXX

FEBRUARY 25, 2025

Once employers and adjusters understand the value of evidence-based medicine (EBM) in workers’ compensation claims, the next challenge is applying it effectively. EBM helps ensure that medical treatments align with standardized recovery timelines, reducing unnecessary disability durations and claim costs.

Workers Comp 80

Workers Comp Injury Workers Compensation Claim 80

Insurance Journal

OCTOBER 8, 2024

California workers’ compensation written premium in 2023 was slightly above 2022, while written premium for the first six months of 2024 is 2% lower than the first six months of 2023, a new report shows. The Workers’ Compensation Insurance Rating …

Premium 277

Premium Workers Comp Compensation Workers Compensation Insurance 277

Insurance Journal

JULY 29, 2024

The California workers’ compensation system has been relatively stable in the post-pandemic era, as premium levels rose by 1% in 2023 and are forecast to increase modestly in 2024—while decreases in average insurer charged rates are moderating, a new report …

Workers Comp 263

Workers Comp Compensation Premium Workers Compensation 263

Insurance Journal

OCTOBER 2, 2024

The road construction firm that employed six workers who were killed and another who was seriously injured in the collapse of Baltimore’s Key Bridge, along with its workers’ compensation carrier, have filed claims against the owner and operator of the …

Workers Comp 203

Workers Comp Compensation Claim Insured 203

AMAXX

OCTOBER 7, 2024

Claims audits and reviews are one of the most commonly used tactics by companies to control workers’ compensation costs. In fact, according to the RIMS 2009 Annual Benchmark Survey, 90% of companies had conducted a claim audit or review of at least some of their claims within the previous six months.

Workers Comp 105

Workers Comp Claim Workers Compensation Compensation 105

AMAXX

MARCH 4, 2025

However, for many workers, an overwhelming fear of losing their jobs adds unnecessary stress to an already difficult situation. Research has shown that fear of being fired is one of the top predictors of negative claim outcomes, including increased litigation rates and extended time off work. Heres how: 1.

Workers Compensation 82

Workers Compensation Compensation Claim Workers Comp 82

AMAXX

FEBRUARY 24, 2025

However, there are times when the NCM doesn’t serve a specific purpose and is assigned to the claim to get it moving. If you review the insurer’s file notes online and do not see NCM notes, contact the NCM for an update. Ask the following: Do you have any suggestions for when we should use nurses and what types of claims?

Workers Compensation 66

Workers Compensation Workers Comp Compensation Claim 66

Insurance Journal

JANUARY 16, 2025

Increases in average medical payments and average indemnity payments drove public self-insureds’ total paid losses up last year even though the number of claims fell, a new report shows. The California Workers’ Compensation Institute reviewed the initial report on fiscal …

Workers Comp 130

Workers Comp Claim Compensation Insured 130

AMAXX

OCTOBER 1, 2024

When managing workers’ compensation, a claim audit or review is a crucial opportunity for employers, carriers, TPAs (Third-Party Administrators), and brokers to come together and optimize claim-handling practices. Here’s how to effectively plan and prepare for a successful claim audit or review.

Workers Comp 102

Workers Comp Claim Workers Compensation Compensation 102

Triple-I: Workers Compensation

FEBRUARY 14, 2025

By William Nibbelin, Senior Research Actuary, Triple-I The workers compensation insurance industry experienced its second-best underwriting result in the past 20 years in 2023, with a net combined ratio of 87, according to Triple-Is latest Issues Brief. A combined ratio under 100 indicates a profit. A ratio above 100 indicates a loss.

Workers Comp 40

Workers Comp Premium Workers Compensation Workers Compensation Insurance 40

AMAXX

JANUARY 6, 2025

When embarking on the journey to master workers compensation, the road is well-traveled and marked by proven strategies. Our three components to achieve workers comp mastery are: Framework , Employer Controls , and External Controls. ” “I asked for surveillance on that claim, and they refused.”

Workers Comp 105

Workers Comp Building Workers Compensation Compensation 105

AMAXX

JANUARY 27, 2025

Click Link to Access Free PDF Download “Step-By-Step Process To Master Workers Comp In 90 Days” Start With Goal of Where You Want to Go We start with a goal of where we want to go. It might be too many claims. It might be too many open claims. This is where we start. We start with a vision.

Workers Comp 92

Workers Comp Workers Compensation Injury Compensation 92

AMAXX

SEPTEMBER 10, 2024

Efficient Communication of Medical Records Communication is critical, especially when it comes to sharing medical records with insurance claims adjusters or your company. By streamlining this process, the provider helps ensure smooth claims management, reducing delays in treatment authorization or return-to-work decisions.

Workers Comp 105

Workers Comp Workers Compensation Compensation Injury 105

AMAXX

MARCH 17, 2025

When applied to workers compensation, understanding these behavioral drivers can reveal how well-intended policies may be unintentionally encouraging behaviors that increase claims, prolong recovery times, or inflate costs. Small injuries go unaddressed, leading to more severe claims down the road. The unintended consequence?

Workers Comp 66

Workers Comp Workers Compensation Injury Compensation 66

AMAXX

SEPTEMBER 9, 2024

Medical cost containment is an essential aspect of managing workers’ compensation claims effectively. Employers and insurance companies face the challenge of controlling medical costs while ensuring that injured employees receive the care they need. A timely review could have prevented an unnecessary claim.

Workers Comp 102

Workers Comp Injury Compensation Claim 102

AMAXX

FEBRUARY 18, 2025

Classification rules are guidelines used by rating bureaus and insurance companies to categorize businesses based on the type of work they perform. The higher the risk, the higher the workers compensation premium for that classification. You should consult with your insurance broker, attorney, or qualified professional.

Workers Compensation 103

Workers Compensation Compensation Workers Comp Premium 103

AMAXX

JANUARY 15, 2025

This is the actual costs of the claims that were legitimate claims for workers’ compensation. He is co-author of the #1 selling comprehensive training guide Your Ultimate Guide to Mastering Workers Comp Costs: Reduce Costs 20% to 50%. So that’s what goes here. This is comes right from your loss run.

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Workers Comp Workers Compensation Premium Injury 95

AMAXX

FEBRUARY 18, 2025

Achieving a 90% return-to-work rate within 0-4 days is the gold standard for managing workers’ compensation claims, with best-in-class organizations reaching 95%+. He is co-author of the #1 selling comprehensive training guide Your Ultimate Guide to Mastering Workers Comp Costs: Reduce Costs 20% to 50%.

Workers Comp 91

Workers Comp Injury Workers Compensation Compensation 91

AMAXX

DECEMBER 19, 2024

In a workers compensation context, this openness encourages employees to report injuries promptly, identify hazards, and suggest transitional-duty opportunities. Early reporting and hazard mitigation are key to preventing costly claims and minimizing downtime. Hire the Right People: Autonomy thrives on trust. All state laws vary.

Workers Comp 98

Workers Comp Workers Compensation Injury Compensation 98

AMAXX

FEBRUARY 10, 2025

Their response in the first moments after an injury determines whether the process leads to a smooth recovery or spirals into an expensive, drawn-out claim. Just as the Eagles didnt let distractions get in their way, companies cant afford to ignore how their leadership shapes workers comp outcomes.

Injury 66

Injury Workers Comp Workers Compensation Claim 66

AMAXX

NOVEMBER 5, 2024

Successfully settling workers’ compensation (WC) claims can significantly reduce costs and streamline processes for employers and insurers. By adhering to a proven four-step process, organizations can consistently achieve better claim outcomes. One key trigger is the injured worker reaching medical stability.

Workers Compensation 105

Workers Compensation Compensation Claim Workers Comp 105

Insurance Journal

MARCH 3, 2025

Defending workers’ compensation claims from employees who have not disclosed previous injuries may have just become a little more complicated for employers and insurance carriers in Georgia. The Georgia Court of Appeals last week found that a long-standing defense against …

Injury 165

Injury Claim Insurance Carrier Compensation 165

AMAXX

JANUARY 20, 2025

In the intricate landscape of workers’ compensation, the pursuit of optimal outcomes for injured workers is paramount. Employers, insurers, and healthcare providers face a delicate balance: ensuring injured workers receive appropriate care while effectively managing costs and promoting timely return-to-work.

Workers Compensation 98

Workers Compensation Compensation Workers Comp Injury 98

AMAXX

FEBRUARY 24, 2025

This structured approach allows medical professionals and claims managers to determine the most effective treatments for injured workers, ensuring care aligns with scientifically validated best practices. Guide claims management Identifying when additional medical evaluation or intervention may be necessary.

Workers Compensation 66

Workers Compensation Compensation Workers Comp Injury 66

AMAXX

JANUARY 13, 2025

Navigating workers’ compensation can be complex, with various parties working together to ensure effective claims management and cost containment. Lets explore the roles of these critical players in a workers’ compensation system.

Workers Compensation 98

Workers Compensation Compensation Workers Comp Broker-Agent 98

AMAXX

OCTOBER 28, 2024

Every session seemed to touch on AI in some form, particularly in how it’s being used in workers’ comp and claims analysis. However, the principles of workers’ compensation will never change. You should consult with your insurance broker, attorney, or qualified professional. All state laws vary.

Workers Comp 105

Workers Comp Workers Compensation Compensation Injury 105