Claim Closer...

Comprehensive Claims Monitoring

Objective:   To assure that all workers’ compensation claims are processed in an accurate and timely manner and that the financial reports are accurate with respect to value and location.  Our goal is to have every one of your claims closed.

Process:   The following describes CDCS’s services:

  • Receive for each indemnity claim a copy of every Employer’s First Report of Industrial Injury, Employee Claim Form and client’s internal supervisory report.
  • On each indemnity claim, require a plan of action from the TPA and a 90‑day report on claims.
  • Supervise all reserve changes.
  • Supervise all legal files and provide TPA with settlement or stipulation authorization on all files.
  • Meet quarterly with defense attorney(s) to strategize claim action plans.
  • Provide client with a quarterly report delineating recent account activity.
  • Provide client-selected personnel with pre-agreed training into the technical aspects of claim evaluation from compensability evaluation, investigation, reduced payments, administrative requirements, case estimates, (temporary disability, permanent disability, medical, rehabilitation, death and allocated loss expense and case conclusion options).
  • Maintain on-line communication with TPA.
Review and approve TPA claims management policies and procedures with written report thereon to assure that it mirrors the claim philosophy of the client.