claims

Workers’ Compensation Claims Resolution

Workers’ compensation claims resolution is different than claims handling. Some insurers “handle” claims—adjusters move them from the “In” box to the “Out” box with a minimum of effort. Occasionally when moving them to another adjuster of a dollar threshold is surpassed. Unfortunately, that often means employers pay the maximum.

 

At Synergy Comp we resolve claims. What does that mean? In simple terms, it means we devote the time, attention, energy, and resources needed to resolve each and every claim within 90 days of the date the injury occurred. In order to consistently achieve this goal—something we do an impressive 82% of the time—Synergy Comp has developed a unique claims adjudication process that is unrivaled for its efficiency and cost effectiveness.

82%

of Claims Resolved in Less Than 90 Days

Communication and total commitment to unmatched customer service are the cornerstones of our workers’ compensation claims resolutions process. Each of our claims managers handles less than one-fifth of the industry average workload and is assigned to work with one account. So as a policyholder, you have one claims contact point, without regard to the size or severity of the claim. As a results, the claims manager has the ability to undertake ability to undertake a rigorous investigation and adjudication process that treats every claim as if it were an indemnity claim from the date of injury to the date of resolution.

Less than 25 open indemnity claims per adjuster.

Less than 60 medical claims per adjuster

It also means that our claims managers can take aggressive action immediately when an injury occurs—a strategy that’s proven time and again to control the costs of each claim.

 

Our claims managers begin the workers’ compensation claims resolution process by establishing and maintaining clear lines of communication with the employer, the injured employee, the physician assigned to the case, and the Synergy Comp loss prevention consultant who works with the client. The claims manager professionally and objectively advises all parties involved of the status of the claim and work with everyone involved to ensure that the employee gets the treatment needed to be able to return to work as quickly as possible. This strategy generates substantial savings for our clients by reducing both the direct and indirect costs of each injury.

3%

of Claims End In Litigation

10%%

Industry Average for Claims Ending In Litigation

Along with facilitating communication, our claim managers utilize all available resources, including independent medical evaluations, surveillance, and the workers’ compensation laws and rules to maintain total control of the claim and resolve it as quickly and cost effectively as possible.

 

Finally, our claims managers work with our loss prevention consultants to identify the cause of the injury and then develop and implement changes or modifications that will prevent similar injuries from occurring in the future. This communication between claims managers and loss control, coupled with ownership commitment to safety, comprise three prongs that create a culture shift toward safety and accountability.

 

Now that you’ve learned more about Synergy Comp’s innovative workers’ compensation claims resolution process, we invite you to compare the service and coverage you receive from your current carrier to ours. Simply download the Synergy Comp comparison form, ask your carrier to answer the ten questions, compare their answers to ours, and then contact us to learn how you can put Synergy Comp’s solutions to work for your business.