What is the difference between AcuComp 7.0 and Claims Case Management?
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We are committed to advocating for the rights of the insured. Once we have obtained the insured’s signed Letter of Authorization we have right to question reserves. We employ that right systematically to yield the best results possible, which, on average, will reduce reserves 30% over time.
Claims adjusters have overwhelming workloads. Claim resolution can take longer than necessary. Additionally, reserves are set for ultimate worker’s compensation settlement and do not reflect the current status of the claim for appropriate unit stat filing purposes. These factors and many more contribute to worker’s compensation total incurred losses typically overstated by 30% – affecting your client’s Mod and premium.
Our dedicated claims team has experience working with adjusters to bring reserves down to a fair amount for unit statistical plan filing. Twice a year we examine reserves and claim file documents to lower reserves. The times at which we question reserves are extremely strategic.
|Annual Reserve Reviews:|
1) Unit Stat Filing
2) Policy Renewal
Claim Status Reports give detailed claim information including but not limited to:
Claim Status Reports are available to our clients online at www.acucomplogin.com.
• Reserves are set for ultimate settlement as opposed to what claim file documents will actually support
• This means reserves are overstated for unit statistical plan filing purposes, which causes inflated experience modification averaging 27 points. Proof of this can be found in an independent state insurance department audit, performed over a five year period, using this system.
• Statute law gives all employers the right to ask insurers at unit statistical plan filing to tie reserves to claim file documents, thereby preventing civil litigation for price fixing.
• The system is web-based, which allows 24/7 real-time access to worker’s compensation claim file information.
• Multiple reports are readily available to quantify the positive impact on experience modifiers.
Claims Case Management
|• Reserve Reductions|
• Face Time
• Client Relations
• Monitors Claim Progress to Closure
|• Difficult to correlate to premium savings|
• No rating bureau involvement
• Time constraints
• Limited to larger accounts
• Staffing limitations
• Competition does it; not a differentiator
Reserve and Mod Reductions Achieved and Measured by:
|• Obtain claim file documents|
• Adjusters update information
• New reserves set: reserves lowered average 30% over time
• Adjusters sign off on confirmed changes in reserves
• Verify correct data on x mod worksheet
• Incorrect data initiates correction card filing by insurer
• X mod drops average of 27 points over time
• Online reports available 24/7
• Reports verify lowered premiums
Presently, NIAS, Inc. is the sole nationwide provider of a turnkey data system that has been validated by a state insurance department to permanently lower experience modifiers averaging 27 points.
Contact NIAS, Inc.
Firm: NIAS, Inc.
5730 Corporate Way, Suite 230
Toll Free: 800-883-5600
Your privacy is important to us and we will not share your personal information with any third party.
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