Controlling Workers' Compensation costs is a process that needs to start at the very top: Those in the C-suite need to commit themselves to creating a zero-injury culture at their organizations, says Calvin Beyer, head of manufacturing for Zurich North America Commercial's customer industry segments.

Establishing such an environ-ment—one that focuses on injury prevention and puts a serious, high-level emphasis on not just reducing but eliminating accidents altogether—is a proven approach to keeping claims to a minimum, Beyer adds.

Top managers must make sure that plant managers, safety directors, line supervisors and everyone down the line knows they are part of a bigger injury-prevention mechanism.

Mary Beth Pittinger, vice president and executive underwriter of Workers' Comp for the Chubb Group of Insurance Cos., agrees that making environmental health and safety a part of the corporate business plan—and putting senior managers in charge of its execution and enforcement—is an absolute best practice for cost control.

But, of course, accidents will happen, even at companies where safety is a CEO's obsession.

And so another crucial aspect of keeping costs down is the proper claims-management process.

A key first step on this front, according to Beyer: the prompt reporting of injuries, as delays can have serious cost implications down the road if a hurt worker stays on the job for a few days before seeking help.

Claims that are reported early and coordinated in a timely manner with adjusters are beneficial to both the insured and the insurer, Beyer says. Early notification allows for immediate corrective action.

"You go from being reactive to proactive," Beyer says. "It allows you to get control of the claim and get it into a [preferred provider organization]."  

And once an employee has made notification of an injury, "make sure you get the injured worker to a quality provider, one that has experience treating occupational injuries," advises Maureen McCarthy, senior vice president and manager of Workers' Comp and managed care at Liberty Mutual.

An injury has happened; it has been expeditiously reported; and the employee has been steered to a qualified treatment provider—so what's next?

Employers should look to build a strong return-to-work program, partnering with carriers and clinics that understand such programs.

VALUE OF THE DATA DIVE

All of the above strategies for controlling costs fall under the responsibility of the employer.

But carriers, too, are constantly looking for ways to limit total exposures.

Many insurers are building and using predictive models to identify "red flag" claims—ones that could be disproportionately expensive to resolve.

"What we try to do is make sure we have a strong program in place to identify potential problematic claims," says McCarthy.

A small subset of high-expense claims actually drive the overall loss dollars, so the company relies on a predictive model as a safety net to catch those types of claims.

At most of its policyholders, less than 50 percent of Workers' Comp claims drive 90 percent of total claim costs, the Liberty Mutual said in a February webinar, "InnovationNow: Experience the Future of Predictive Modeling." These involve both catastrophic losses and what the company calls "outliers": claims that morph into high-expense claims due to such risk factors as an employee's co-morbid medical conditions—hypertension, diabetes or obesity.

"The earlier that we're able to identify these cases provides us with the time that we need to work with the injured worker—to make sure that what should have been a small, benign Workers' Comp claim doesn't become a high claim," says McCarthy.

Employers, too, with help from their brokers, are using data to, for example, identify which vendors can have the greatest impact on their outcomes. 

Marsh's Variable Cost of Risk Evaluator (VCORE) software tool compares data from competing claims administrators in terms of actual medical costs and claims-administration fees, then calculates the anticipated Workers' Comp variable costs. Clients can then select the vendors that will have the biggest impact on their claims handling.

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