Effective Workers Comp Reserve Reviews

This is the area that seems to be the most misunderstood. We often have employers contact us about a loss run they had just received or about how their E-Mod increased so rapidly in one year.

We often recommend that the employer obtain a copy of their loss run. Your insurance carriers will provide a copy on request. The Work Comp carriers will usually provide a loss run quarterly.

Please remember that only the OPEN claims can be dealt with, as a closed claim or the previous reserves on a closed claim cannot be questioned later on. That is why it is so critical to track the claims as they develop. Discussing a reserve that was opened on a claim three years ago will not do any good. In other words, when a loss run is received, it should be reviewed on receipt.

Things to look for in a Workers Comp loss run are:

• Old claims still open
• Resolved claims still open
• A small amount of indemnity total incurred with a large amount of medical total incurred, or vice-versa.
• A large increase in reserves or total incurred on a claim
• A re-opening of a closed claim
• The total incurred does not match the claim, such as a large amount of reserves on a minor injury
• The injury listed does not match the employee's injury
• An injured employee's name that you do not recognize
• Anything that just looks out of place.
• Many others

UP NEXT- Contacting your adjuster if you find something questionable.