Leveraging Excess Carrier Expertise in Catastrophic Claims

Your excess workers’ compensation carriers possess unique expertise in the industry. “Excess carriers routinely see the worst work injuries, resulting in larger and lengthier catastrophic claims, and offer employers a considerable ally in the plan for the best possible outcome for an injured worker,” says Stephen Peacock, Assistant Vice President of Claims at Safety National.

Here are seven resources to discuss with your excess carrier when faced with long-term costs associated with catastrophic claims.

1. Medical Teams

Your excess carrier’s vast experience brings with it a team of in-house nurses and/or physicians with prior extensive catastrophic medical experience, and sometimes, actual claim handling experience. These experts routinely handle the worst medical conditions, so they have resources and contacts nationwide available for assistance or consultation.

2. Nationwide Centers of Excellence

While your self-insured workers’ compensation program may have resources for simple medical claims, utilizing your excess carrier in more unique cases can prove beneficial. Your excess carrier commonly works with the best specialists in the country, knowing where the premier medical facilities are located. While costly, getting the most appropriate treatment helps to achieve the highest recovery possible. Open communication with your excess carrier may provide access to better price-reducing measures too.

3. Opioids and Medical Equipment

While prescription opioid deaths have continued to drop since 2018, it is critical that these medications are prescribed and dosed accurately. Thankfully, your excess carrier has access to expert pharmaceutical contacts to answer any questions regarding medication type and dosage frequency while advising your excess carrier on the most successful drug review programs. These contacts also frequently research the most durable, quality and affordable medical equipment on the market.

4. Bill Review

Tackling the ever-increasing inpatient hospital bills and surgery costs can feel insurmountable in a catastrophic claim. With the assistance of your excess carrier and their familiarity with bill review companies, costs can be cut significantly, even after the usual state fee schedule reductions.

5. Home Modifications

When it comes to home modifications, taking the most proactive approach proves to be most cost-effective. Often general contractors are hired with little expertise in extensive modifications, requiring work to be undone and redone. Your excess carrier can help find an expert contractor familiar with workers’ compensation, ADA rules, and permits who can help recommend the best solutions.

6. Attendant Care and Transportation

In the event that an injured worker may require attendant care, when is the best time to plan for accommodations? If there is a reasonable expectation, do not hesitate to involve your excess carrier. When settlement is not an option, they can offer valuable, competitively priced resources like premier living facilities, attendant care providers and transportation needs.

7. Settlements

We all know that the longer a workers’ compensation claim stays open, the more expensive it becomes. So when do you decide that settlement may be the best option when faced with the uncertainty of increased, long-term medical costs? First, use your excess carrier to explore ways to reduce your exposure, then in the event of a settlement, use your excess carrier to guide you through the unique territory surrounding these claims. It is imperative that settlements are written clearly and reflect the advantages and disadvantages of settling so injured workers fully understand their options. The expert advice of your excess carrier can bring perspective and comparison that attorneys may not offer.

We are all looking for ways to reduce costs, but your excess carrier will do so without sacrificing the medical care that the injured worker so desperately needs to reach optimal outcomes. Understand the value and individualized experience they can bring and include them regularly as part of your claims team.