Self-Insured Workers' Compensation Services
For those entities that meet the Ohio Bureau of Workers’ Compensation guidelines and that can bear the risk financially, self-insurance can be the most cost effective way to provide the state mandated coverage.
Self-Insured Workers
Claims Management and Control
Hunter Consulting maintains a staff of experienced claims personnel. These professionals are trained to manage claims from the client’s perspective. Their objective is to provide expert services with an ultimate goal of reducing your claim costs. Our claims staff will work closely with you to promote a frequent exchange of information necessary for effective claims management.
The following guidelines provide the format by which your Hunter Account Manager will manage your claim.
Investigation Management
Your Hunter Account Manager will promptly investigate the incident leading to injury to determine the claim’s merit.
- We meet with the client to discuss paper management and work flow.
- We discuss the most efficient means of claims reporting to protect your self-insured privilege and deliver benefits to legitimately injured employees.
- We provide an internal audit of your claim files to ensure compliance with rules and regulations as required by Ohio Bureau of Workers’ Compensation.
Reserves
Hunter Consulting reserve philosophy is to accurately present to the client their ultimate exposure as soon as it is known. This requires a thorough review of:
- Attending physician’s diagnosis of the claimant’s condition
- Medical treatment required
- Statutory benefits
- Anticipated duration of a disability
We provide an assessment of damages resulting from legal liability or accident compensability and the most probable outcome based on the case in its entirety.
We establish an initial file reserve within 24-48 hours of receipt of the first report.
The reserve amount is reviewed every 30 days by the Account Executive and adjusted if the facts surrounding the claim warrant change.
We’ve Helped Many Clients Enroll
We have helped hundreds of employers enroll through our statewide network of sponsors. As new employers, you will have access to the same benefits as each of our established clients – including:
Experienced claims managers
Manual Classification Review
Attorney representation at the industrial commission
Semi-Annual Safety Training
Claims Settlement
Negotiations commence as soon as sufficient evidence to establish a fair settlement value exists. During the course of negotiations, your Account Manager will:
- Notify you of developments
- Maintain proper file documentation
- Coordinate efforts with appropriate parties
Settlement valuation is a process to determine an effective means of resolving a claim. Our objective is to manage settlements to a fair and equitable conclusion.
Rehabilitation Management
Our Account Managers are trained to handle much of the medical management as a normal part of their daily claims practice. Under certain circumstances, it may become necessary for a file to be referred to an outside service. Vocational rehabilitation is recommended on a selective basis.
A recommendation might be made in situations involving:
- Catastrophic loss
- Protracted period of disability
- Permanent medical restrictions
- Uncooperative or troublesome claimant
Your Account Manager closely monitors all rehabilitation efforts whether they are of a medical management nature or for a job search. An outside rehabilitation service is not utilized without your prior approval.
Fee Bill Processing
All fee bills are reduced to the appropriate BWC UCR schedule. Hunter then applies a PPO price that further reduces your bills. In addition we have special PPO arrangements on prescription drugs and diagnostic studies such as MRI’s, CT Scans, etc.; these arrangements allow Hunter to further reduce your bills from 9% to 21% below the BWC’s UCR schedules.
Subrogation
Subrogation is the process by which the Self-Insured employer recovers medical and compensation costs paid on behalf of an injured worker when a third party is liable for the injury.
Details
Ohio statute gives a right of subrogation to the BWC, self insuring employers and certain employers who contract for the direct payment of medical services. This gives the BWC or self insuring employer the right to collect back the costs of the claim from the person or entity who caused the accident. Recoverable costs include all past, present, and estimated future payments of compensation, medical benefits, rehabilitation costs or death benefits paid to or on behalf of the claimant, subject to formulas established by the BWC.
What claims can be subrogated?
- Premises liability (slip and fall not on company property)
- Product liability (machine malfunction)
- Medical malpractice
- Construction site accidents (caused by third party)
- Dog bites or animal attacks
- Car accidents
- Complete the BWC safety survey.
- Read an introduction to the Division of Safety & Hygiene’s offerings
- Complete at least 2 hours of safety training provided by the Division of Safety & Hygiene
The safety requirements must be completed by all Grow Ohio Participants prior to the end of the first full reporting period after being accepted into the program.
Subrogation Management
Your Account Manager will determine if a claim involved a liable third party. Your Account Manager is responsible for:
- Identifying the liable third party
- Pursuing subrogation against that third party
- Initiating efforts to recover all costs expended in the claim including future reserves
- Managing the subrogation efforts to conclusion
A Feasibility Study is provided to determine any financial advantage to being self-insured.
Once the application for self-insurance has been submitted to the Ohio Bureau of Workers’ Compensation, Hunter Consulting begins designing a plan customized to meet the individual client’s needs
- We meet with the client to discuss paper management and work flow.
- We discuss the most efficient means of claims reporting to protect your self-insured privilege and deliver benefits to legitimately injured employees.
- We provide an internal audit of your claim files to ensure compliance with rules and regulations as required by Ohio Bureau of Workers’ Compensation.
Let’s Get Started
Ready to Optimize Your Workers' Compensation Program?
Whether you’re looking to reduce costs, simplify your processes, or ensure you’re getting the most out of available incentive programs, Hunter Consulting is here to help. Our team of experts is ready to analyze your current situation and develop a customized strategy to meet your needs.
Take the first step towards a more efficient, cost-effective workers’ compensation program. Contact us today for a free consultation.
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