Insurance Claims Management Services

Lykes Insurance offers Claims Management Services (CMS)....

Claims Management Services (CMS) is a division that provides workers' compensation claims management and loss prevention consulting services.

For most employers, paying workers' compensation premiums is their second largest expense behind payroll. However, few have a clear understanding of the development of the experience modification factor and the control they can have over the net cost of workers’ compensation insurance coverage through claims management and loss control. By partnering with CMS, employers have an advocate in the management of this premier line of workers compensation insurance coverage.

CMS can partner with you in the following areas:

Telephone Consultation
A CMS Claim Consultant is available for personal telephone consultation on serious injuries that occur. Your consultant will offer advice on direction of medical care and development of an injury plan for the employee, recommendations for insurance claims management procedures and specific claim reviews.

Claims Management & Tracking
CMS reviews loss runs from carriers for open claims. The CMS Claim Consultant will then follow up on each open claim with the insurance carrier claim adjuster. Specific services include:

• Analysis of an injury through review of insurance adjuster's notes and conference with employer.
• Return to work program consultation and coordination.
• Attendance with employer at hearings, depositions and mediations if necessary.
• Written reports of all open claims with appropriate recommendations.
• Periodic on-site review meetings.

Mod Analysis
An important and somewhat confusing component of your Workers’ Compensation policy is the Experience Modification Factor. To effectively manage the cost of your WC program, you need to have an understanding of how the experience mod factor is developed and take proactive steps to control it. With a large percentage of experience mod factors calculated incorrectly, it is essential that you have a specialist review the accuracy of the calculations and data on reported workers compensation claims.

Lykes Insurance Claims Management Services can provide you with a comprehensive analysis of your experience mod factor to check for accuracy and provide direction on how to more effectively manage it to the absolute minimum.

Loss Control Services
Loss Control Services. Few employers can afford to hire a trained safety director, yet an active and effective loss control program is essential to controlling the direct and indirect cost of claims.

CMS can provide customized loss control solutions in the following areas:

• Written Safety Program – can help qualify your company for the 2% Safety Program Credit on your workers’ compensation policy
• Job Safety Analysis – job site safety and OSHA compliance inspections
• OSHA Compliance – review facility and records for OSHA compliance
• Safety Committee Participation – CMS Loss Control Consultant will attend and conduct safety meetings for employers
• Training Programs – training programs for supervisors and hourly employees
• Personal Protective Equipment – (PPE) Assessment
• Drug Free Workplace Program – can qualify your company for the 5% Drug Free Workplace Program Credit on your workers’ compensation policy
• Accident Investigation – documentation of relevant accident site issues
• Incentive Based Safety Program Design and Implementation

This is just a sampling of insurance claims management services available to employers through CMS. Contact us for creating customized workers compensation solutions to your safety and loss control needs.