San Diego, CA – American Claims Management, a national third-party claims administrator, recently announced that it has created a Claims Advocacy Program that delivers empathetic claims service while reducing workers’ compensation costs for employers and insurance companies.
“Restoring the health of injured workers is and should be the goal of workers’ compensation coverage,” says Dhara Patel, president of American Claims Management. “Our Claims Advocacy Program puts that goal front and center by bringing empathy, compassion and patience to support an injured worker.
“We’ve found that patiently listening to an injured worker and following an established protocol to advocate for their health gets people back on the job faster and away from the distraction of a legal process,” Patel says. “The Claims Advocacy Program has helped us resolve claims faster with less litigation and lower payouts, because the patient observes that the insurance company or employer is working with them, rather than against them.”
The American Claims Management Claims Advocacy Program encompasses:
- Protocols in the claims process to ensure that the injured worker’s voice is heard.
- A dedicated return-to-work program and head injury claims program.
- A pre-surgery pain screening program.
- Utilization review in the event of claim denial for surgery, including communication with the injured worker and with the requesting physician on a course of treatment.
- Early intervention for high-risk claims, triggered when certain elements are present.
“The good results we’re seeing in lower claims costs and faster returns to work are due to the Claims Advocacy Program protocols we’ve put in place, the training of our claims professionals, and the review and accountability to which our team commits,” Patel explains. During the program’s first quarter, disability payments shrunk to less than half and legal expenses were reduced by nearly $400,000.
The Claims Advocacy Program is available to injured workers under workers’ compensation accounts serviced by American Claims Management throughout its national footprint. This includes the Arrowhead Workers’ Compensation Program, a monoline workers’ compensation program offered in Alabama, Arizona, California, Georgia, Nevada, North Carolina, South Carolina and Tennessee. American Claims Management, a division of Arrowhead General Insurance Agency Inc., developed the program over the past several years while working with a long-time insurance carrier customer.
Source: American Claims Management