Effective claims management

Legal requirements for recording and reporting work-related injury and illness 

Workers comperrsation and accident data can be collected manually or on a computerized irrformation system. The size of an organization will usually determine what accident data is collected. Certainly, workers comperrsation claims information will be maintained by orgarrizatiorrs, as the claim will have to be processed by the employer. Companies can obtain statistical workers compensation data from their irtsurer in the form of printed reports. 

Use of workers compensation data to identify and assess risks 

Workers compensation data - risk control strategies 

Whatever the source of workers compensation data is, it provides valuable iirforma-tion on specific injury trends. These trends include  

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Managing Workers Compensation A Guide to Injury Reduction and Effective Claim Management, Keith R. Wertz and James J. Bryant... 

One of these is more effective claims management. The national health and safety manager recounts how, when he first took on his job, he discovered more than a dozen people who had been off on workers compensation for more than three months and were clearly costing the company dearly. He went to visit each one at home and managed to get them all back to work on alternative duties. 

The Bayesian network technology embedded in the ARBITER tool is also well suited for learning both probability relationships (e.g., method reliability estimates) and the essential structure of cause and effect, from data sets where predictions and outcomes can be compared. Colleagues have already applied this capability on a large scale for risk management (selection of potentially suspect claims for further inspection and examination) in the insurance industry. 

In both the roles, insurance companies deal with the management of risk activities. In fact, climate change risk is managed by the insurers through the risks they accept from clients, given that climate change causes an increase in intensity and spreading the distribution of extreme weather events with resultant effects on property claims that could be catastrophic.5... 

In those jurisdictions where a formal workers compensation system is in effect, the compensation health records provide the most definitive information available because the medical, social, and work history of each employee who applies for workers compensation is investigated in comprehensive detail and is made available in large part to management. Currently, relatively few illnesses, as compared to injuries, are considered for workers compensation claims. However, if a cluster can be found with the same type of complaint, that information can be invaluable. Similar information can be obtained from private insurance companies who provide employee coverage in place of workers compensation. 

Advertisers managed to find ways around the restrictions, however. For example, Merrill-Dow, the maker of a new antihistamine called Seldane, claimed that its product made users less drowsy. Ads for the drug did not mention it by name and therefore did not need to summarize risks and side effects. Rather, the ads merely said that a new drug for allergies was out, it did not make users drowsy, and doctors could provide more information. The 1988 ad campaign was hugely successful, and sales of Seldane soared. 

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