![]() ![]() ![]() If for any reason coverage has not been verified, contacts not completed or the reserving cannot be done, the adjuster’s Action Plan should reflect the item(s) that are outstanding from the initial handling and provide the due date for the follow up on those items to be completed. You should see file notes reflecting coverage was verified for the claim, that the employer contact, employee contact and physician contact was completed and the initial reserves were placed on the file.Īll of these items should have been completed before the adjuster does the initial Action Plan. ![]() If your adjuster is following the Best Practices set by most insurers and third party administrators, the initial claim handling was completed the day the claim was received in the claims office. Initial Claim Handling Completed Day Claim Received You should see at minimum the date due and the date completed for each of the items in the adjuster’s Action Plan. ![]() The adjuster’s file notes should state what was accomplished and what needs to be accomplished to move the file forward.Įach of the items that need to be accomplished should be given a due date and placed on the adjuster’s diary (calendar) for completion. When you go on-line to review the adjuster’s file notes on your company’s lost time work comp claims, do you know what you should see in the adjuster’s Action Plan? If you have not been a work comp claims adjuster, it would be easy for you to miss items overlooked or missed by the adjuster. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |