Q. What services does your carrier or TPA offer with your premium?  

A. Services provided by the Insurance Carrier or Third-Party Administrator are usually dependent on the premium size of an account. You can ask what services are available.  

What services will help you manage your Workers’ Compensation claims?

What does the carrier or TPA offer in each of these categories?

Here are eight services that can be negotiated with the carrier at policy inception or renewal.

1. On line access to Claim Notes and Reports

   • For reporting injuries

   • To run reports/ loss runs.

   • Or scheduled monthly or quarterly loss runs sent directly to the insured

   • To review adjuster claim notes

   • To review payments of Temporary Disability and other claim costs

2. Quarterly claims reviews

   • In person and/or telephonic claims reviews with the claim’s liaison or the claim’s adjusters to review action plans and reserves

   • Carrier provides written claim status reports to all participants 1 week before the scheduled claims review to maximize value and participation by all

3. Designated claims examiner for all Indemnity claims

   • Carrier to provide a contact list for claims team, supervisor, claims liaison

   • If you have numerous claims per year, can you have one designated Indemnity claims adjuster who you can develop a relationship with?

4. Claims Notification

   • Email notification of claims being opened, closed, denied, reserve changes >$10,000

   • Email notice of start/ stop Temporary Disability (if you have 50 or more employees, this will be the trigger to start to run FMLA concurrently for eligible employees)

5. Return To Work

   • Email notification of all work statuses to plan for modified or alternative work duties

   • Coordination and cooperation with negotiating physician work status, job descriptions

6. Medical Provider Network

   • List of all MPN clinics in the employer’s Zip Code(s)

   • Assistance with establishing employer protocols with the clinic

7. Litigation Management

   • Employer participation in the selection of a designated defense attorney

   • Notice of all Hearings, employee depositions, Status Conferences

   • Notification of all settlement recommendations

8. Safety/ Loss Control

   • What services are available?

   • Initial appointment with the Loss Control consultant to determine the employer’s needs.