Rising Administrative Costs, Data Saturation & Claim Cost Solutions

When is too much data, too much?  In a data driven industry, the in-consumable amounts reviewed on a daily basis for the justification of risk decisions may just be part of the culprit for higher claim costs. Data saturation inhibits the ability when reviewing and collecting this information which becomes less productive for employees. Based on the Lockton report of 273,000 claims from 2013-2017 with a short option by risk and insurance.com link attached ( http://riskandinsurance.com/opinion-this-denied-claims-data-is-turning-heads/) provides an eye opening article of information about rising costs of denied workers compensation claims which could have clearly been avoided. Claims initially denied only to be approved one year later carried a 55% higher cost per claim.

This independent article from risk and insurance provides yet again, validation of our models with the shift that continues to transpire in the industry moving towards an advocacy based cost effective approach with exploring new management strategies for resolutions of claims. Carriers, Employers, and Third Party Administrators that continue to subscribe to such an archaic model by taking a hard stance on disputed claims when trying to achieve a reserve mark on a claim, more often than not, will drastically overspend in trying to achieve this desired resolution based on national costs averages, incurring unnecessary costs.

The claims advocacy side tells us there is no one size fits all standard approach. An advocacy service must be custom tailored to your company’s specific needs, as each claim is unique. This makes it difficult for untrained in-house claims managers to implement. A qualified advocate will solidify the trust in a new claimant relationship within the first 30 days of injury or less. Utilizing an outside advocacy service with a previous claimant to new claimant model creates a unique bond that can’t be matched by any other service. No one can understand what a current claimant is going through, unless they have been in their shoes. The trust factor that develops here is one that no adjuster, advocate, or counsel can emulate, unless they have had direct experience navigating their own workers’ compensation claim.

The goal of claims advocacy is to achieve greater satisfaction for the injured worker. To ensure success, the advocate must also maintain an open dialogue with carriers, third party administrators, and/or employers. Part of this open dialogue includes providing them with valuable feedback that emphasizes strategies for reducing cost expenditures on claims. The direct impact is a decrease in future claim and litigation costs that vastly improves the carrier’s bottom line while helping claimants return to work faster, moving out of this system and on with their lives.

I have devoted all my time to codifying and refining the most innovative and efficient method for settling workers’ compensation claims in addition to our advocacy approach process. Our models are the best within the industry today for our clients.

Let PG Resolutions Group bring your company into the 21st century for claims advocacy and one day settlements.

Stop overpaying for claims and services today!

Contact us to learn more.

Written By:

Paul Gold

Founder & CEO

PG Resolutions Group