This program is remarkably successful for our clients.

Our in-house Claims Shadowing Unit works with our clients and all involved parties -- carriers, TPAs, legal and medical professionals and more -- to isolate and actively manage large, problematic and/or fraudulent claims to resolve and close as quickly as possible.

We provide our clients with the most comprehensive, proactive claims management services focused on minimizing overall claims expenses. We become our clients' personal, expert claims advocate.

The Results

Claims shadowing works to significantly impact loss expense ratios, lowers rates and ultimately creates the positive financial impact that places our clients at an advantage against their competitors.

Here are just a few examples of the program savings we have generated for our clients through aggressive claims shadowing.

National Non-profit in Disease Research -- Non-profits struggle enough without the burden of high modification factors hurting their bottom line. When this client came on board, there were 12 large claims impacting their modification factor. Their mod was 260 at the time. We were able to identify multiple claims that were too complicated for the adjuster assigned to the account. We were successful in moving the claims to a new claims adjuster, with 15 years experience. At the same time, we made recommendations on reserves, settlements and creative ways to finalize the open claims. Today this client's experience modification is down to 144 (121 points below where they started) and they have realized annual premium savings of over $256,000.

California Community-based Non-profit -- We identified multiple claims that were not being aggressively handled by the claims management team. We held multiple claim reviews with the carrier and the employer. We recommended safety incentive programs and loss control for preventative measures, but at the same time when those accidents did occur the client immediately reported the claims to the Claims Shadowing department. In turn, we set up and monitored the claim for appropriate handling, plan of actions, and reserving techniques. This client's experience modification factor was at 163 and is currently at 113 (reduced by 50 points), with an annual premium savings of over $90,000.

Elder Care Services Company -- When they came to us, this client had an experience modification rate of 133 which was primarily due to frequency of claims rather than large dollar claims. We implemented a First Aid Program. Their experience modification factor was recently reduced to 76 (reduced by 57 points), and they have realized an annual premium savings of over $118,000.

Family Services Company -- This client did not have many claims, however the few they had were large dollar claims. Dana Harrison of our Claims Shadowing Department was able to identify a lack of experience from the adjuster assigned to the claims, and made recommendations to the adjuster that ended up not only reducing the client's experience modification factor, but was able to save the carrier $100,000.00 on a particular claim. The adjuster was prepared to settle the claim for over $130,000 based on the treating physician's work restrictions, however, Dana was able to convince the adjuster that the objective evidence did not support the objective findings and recommended a Panel Qualified Medical Evaluator (QME) to evaluate the injured employee. The QME found some permanent disability, wrote an excellent report and the case was settled for $30,000.00. Their mod rate was 159 and is currently 90 (reduced by 69 points), and their annual premium went from over $32,000 to just under $6,000 -- a savings of over $26,000 or 79% of their premium.

Northern California Hotel -- This client had open claims wherein a few of the injured workers were magnifying their symptoms to the point that the insured felt they were defrauding the system. However, the insured was unable to get the carrier to prepare a potential fraud case. The Claims Shadowing adjuster was able to convince the carrier to hire a Sub Rosa Investigator, who is currently investigating those claims. Some of their other claims were large dollar claims and we were successful at settling the extremely active claims. Their experience modification factor fell from 195 to 78 (reduced by 117 points). The fraud claims are currently under investigation. And their annual premium fell from over $154,000 to $21,000, a savings of over $133,000 or 80% of their premium.

Solid Waste Handling Company -- This account did not have many claims; however, the claims they did have seemed to linger. Also, it was surprising that prior to coming to us, this large premium account had never had a claims review. We identified the problem claims and obtained status on all their open files. We also scheduled a face-to-face claims review. At the review, we were given detailed narrative reports that addressed reserves and a plan of action on each claim. This enabled us to determine whether the claims were reserved and being handled aggressively. We now schedule claims reviews twice a year, which is a reminder to the claims department that we are involved, and this keeps their files moving towards closure. Their experience modification factor has fallen from 103 to 64 (reduced by 39 points). And their premium went from $760,000 to just over $445,000, a savings of over $315,000 each year, or over 40% of their premium.

Mortgage Lending Company -- This employer has very few claims, and we have been successful closing all claims as soon as possible. We have discussed claims issues, which helps the employer understand the workers' compensation system a little better. Their experience modification factor was a relatively good 93, in 2006 it is a better 71. Prior to coming to our brokerage their annual premium was $82,000, but now it is at $32,000. A savings of $50,000 annually, or over 60% of their premium.

Adult Career Training Company -- This client had several open claims. We immediately requested narrative reports from the carrier. Once the reports were completed, we scheduled a face-to-face with the client and had the adjuster on a conference call. We identified the claim issues, addressed reserves and developed a plan of action. We continued to follow-up with the carrier to keep the claims on track. This employer has also taken advantage of our First Aid Program and our claims education services. Together with the client we contacted the WCIRB for a recalculation of their experience modification factor. We had to ensure proper information was provided to the WCIRB by the carrier, as there were a few claims that had liability and subrogation issues. Their experience modification factor has fallen by 28 points and we expect significant premium reduction.

Medical Clinic -- This medical office specializes in workers' compensation, so their employees know the system which makes it extremely difficult to close files. When this client came to us and we started to shadow all the open claims, there were many issues that needed to be addressed. We identified all indemnity claims and established a plan of action. We also identified medical-only claims that could potentially become a problem. We worked with the adjuster and initially obtained status once a month to ensure claims were continuing to move forward. Several claims have now been closed. The key to our success with this client has been to shadow claims immediately. Their experience modification factor was 141 and has fallen to 111. Annual premium was $423,000 and has fallen to $338,000, a savings of over $85,000 per year.