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An effective injury investigation ensures that only valid claims proceed, protecting both the company and legitimate injured workers. Conduct Regular Claims Reviews : Work closely with your insurancecarrier or third-party administrator (TPA) to review open claims and identify inconsistencies. All state laws vary.
TPAs operate independently of the insurancecarrier, focusing on streamlined claims handling rather than insurance services. Click Link to Access Free PDF Download “Step-By-Step Process To Master WorkersComp In 90 Days” 3. Do not use this information without independent verification.
As a result, the workers’ compensation insurancecarrier decides not to pay for the treatment until they determine the claim’s compensability. Simultaneously, because the injury was reported as work-related, John’s group health insurance also refuses to cover the treatment. All state laws vary.
Evaluation of all these defenses requires cooperation and coordination between the insurancecarrier, employer, defense experts, and legal counsel. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.” All state laws vary.
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