KMA Claims Management
Whatever your type of business, exposure to risk of loss can and often does result in claims. Observing the frustration businesses frequently encounter when working with claim adjusters, KMA developed the Claims Management division. This fee-based service is designed to assist clients with managing their claims, especially workers’ compensation claims, from the time claims are reported to the insurer, to the time each claim is closed.
What is the overall purpose of Claims Management?
Businesses managing claim activity have learned that unbundling the insurance claim function no longer assures them of problem free claims management, rather, just a marginal improvement over the typical insurance claims adjuster. KMA Claims Management expands your business’ ability to technically manage the claims adjuster’s attention to your claim. KMA increases communication between your claims person and the claims adjuster. We advocate your interests to promote cost effective and timely resolution of all claims.
How does the Claims Management process work?
Initially, KMA Claims Management can educate your business’ claim contacts, managers or supervisors with regard to reporting, investigating and administering claims, and help define your business’ loss control philosophy which can positively impact your loss experience, marketability and cost of your insurance program.
KMA’s system monitors and tracks the activities of the claims adjusters who process claims, including workers’ compensation claims. For each claim KMA makes certain that the claim adjuster has a thoughtful, technically sound and timely action plan, beginning on the day the claim is received by the insurer. We continue to oversee the activities of the adjuster until the claim is closed. This oversight enhances the insurer’s handling of your claim with respect to:
- Investigation for compensability
- Light duty options
- Disability and medical management
- Reserving levels
- Litigation management
- Third party recovery opportunities
- Timely closing
- Reporting on claim tailored to your needs
In our Claims Management practice, we have seen that workers’ compensation claims are becoming enmeshed with greater frequency with employment law concerns. More and more, issues such as disability, age, sex, race, unequal pay and wrongful termination are raised in the context of workers’ compensation settlements. KMA can provide seamless solutions for your business to ensure that all potential exposures are dealt with whether those risks are insurable or not. Examples include assistance with:
- Americans with Disabilities Act
- Family Medical Leave Act
- Age Discrimination in Employment Act
- State Human Rights Acts
- State Workers’ Compensation Acts
- Equal Employment Opportunity Commission matters
- Documenting employee performance and discipline
- Issues in the union environment
Why do KMA clients benefit from Claims Management?
KMA’s Claims Management solution operates seamlessly with carriers and third party administrators to assure that optimal attention is given to controlling the cost of your claims. We seek to advance your goals of significant improvement in your loss experience, resulting in lower workers’ compensation experience modification, which leads to improved marketability of your insurance program. The bottom line result sought is reduction in your premium costs, especially workers’ compensation premiums.
Useful links:
Minnesota Dept. of Labor & Ind. www.doli.state.mn.us/workcomp.html
National Workers Compensation www.workerscompensation.com
Understanding your experience modification www.ncci.com/media/pdf/abc_Exp_Rating.pdf
Experience modification calculator www.mwcia.org/ModCalculator.htm