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Mistake: Accepting Every Workers’ Compensation Claim

AMAXX

This opens the door to exaggerated injuries, unrelated medical issues being attributed to work, and even outright fraudulent claims. Heres how: Establish a Clear Injury Investigation Process Not all injuries that occur at work are work-related, and not all reported injuries are legitimate.

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Why Reporting Small Claims Pays Off in ERA States

AMAXX

Many employers wonder: “Why report a $1,000 medical bill to the insurance carrier if we can just pay it ourselves and keep our experience mod low?” After all, fewer claims mean fewer red flags on your insurance history—right? The insurer might resist covering it—or even deny the claim—leaving the employer exposed.

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Workers’ Comp Is a Team Sport: Understanding the Puzzle of Stakeholders

AMAXX

When a workplace injury occurs, most people think of two parties: the injured worker and the employer. Insurance Carrier The carrier underwrites the policy and carries the financial risk for claims (in guaranteed cost programs). For self-insured employers, the TPA is typically the frontline claims handler.

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Working With Unions on Return-to-Work: 8 Steps for Gaining Support and Avoiding Conflict

AMAXX

Audit your policies for: Wage continuation programs that exceed pre-injury earnings (especially since workers’ comp is tax-free) Accrual of vacation/sick time during time off Seniority rules that reward time away from work Other “perk continuations” like gym memberships or car allowances Work with union leadership to address these disincentives.

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Understanding the Key Parties in Workers’ Compensation

AMAXX

Third-Party Administrator (TPA): Claims Specialists For employers who are self-insured or insurance companies without an in-house claims department, TPAs play a crucial role. TPAs operate independently of the insurance carrier, focusing on streamlined claims handling rather than insurance services.

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Avoid 2 Common Pitfalls That Delay Care in Workers’ Compensation Claims

AMAXX

This delay typically occurs when there is uncertainty about whether the injury is work-related, resulting in neither workers’ compensation nor general health insurance covering the initial treatment. Example: Consider John, who reports a shoulder injury first thing on a Monday morning.

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Increase Your Commissions by Selling Disability Insurance

Word & Brown

Having disability insurance can help an individual maintain a regular income (and associated lifestyle) when unable to work due to a new illness or injury. Disability insurance can help your clients avoid depleting their emergency funds or retirement savings when facing disability. LTD plans may differ.