Workers’ Compensation
Claims Advocacy
Our goal is to minimize the impact of any losses you may experience.
Experienced Advocate
Our dedicated team is responsive, experienced and results-focused.
Each Claims Advocate has extensive experience in the administration of workers’ compensation claims and is uniquely qualified to work aggressively on your behalf.
Services
Available on all open claims on all policy years
Thorough analysis of the injury through a review of carrier’s claims notes and direct contact with both the claims examiner and employer
Provide oversight of the insurance company’s reserving logic, treatment plans and claim closure timetables
Send 90-day written reports on all claims to the employer
Telephone claims meeting with employer as needed
Attendance at carrier claims review meetings as needed
Assist in Return-To-Work design and coordination
Client Testimonials
“I want to formally recognize Jim Malone for his superior service as a my workers’ compensation claims advocate. As many HR professionals know, it is imperative to create relationships with knowledgeable and trusted experts who can help fill in the gaps when dealing with sensitive issues. Jim has always made me feel like a priority, responding to my questions quickly, proficiently, and without making me feel like a burden. Not only is Jim thorough in his responses, Jim offers an extra touch of humanity with his congenial personality. I am grateful that Jim is working on my side.”
“I wanted to shoot you a message about Jim. He is my contact on one of my most challenging cases and he has been wonderful to work with. He is a claims advocate that works with me and not against me. That is uncommon these days and is very refreshing. His knowledge of HR, employment law and workers' compensation is by far superior to any other claims advocate I am presently working with or have ever worked with in the past.”
“Jim has been a great resource for our remodeling company! His vast experience coupled with his ability to explain the complex world of worker's compensation has been extremely helpful. The nuances of insurance can be brain numbing, but Jim does a great job staying focused on the issue at hand and offering his advice. Jim even attended our Project Manager meeting to discuss our safety culture and to field questions. This was greatly successful as Jim can speak from a lot of experience and has many examples to give. We love working with Jim and highly recommend his service.”
“Jim has been a great resource for me. He is very good at explaining the process in standard English and not all the abbreviations the adjusters use. I wish we started working with your team sooner. Just good to know we made the right choice this year. Thanks for all your help.”
"What I loved about my experience is Jim didn’t just tell me what needed to be done and then hang up, he instead stayed on the phone with me while we found a medical center for the employee. He let me know what forms I needed to fill out, helped me find them and instructed me on who they would need to go to. He took me through the process step by step, even instructed me on the importance of the employers interview, telling me what questions to ask and how detailed they needed to be. I truly felt like I had a partner! He also took the time to tell me what will need to be done in the next few steps and assured me that if I had any questions, he was there for me. I loved the customer service."
"We are excited to be a new client of Rancho Mesa! They have hit the ground running with excellence. I have been very impressed with how on top of it they are. They do everything with the utmost professionalism. I am even more thrilled that they were able to close 6 of our claims within the first 3 months."
"Jim Malone is helping me navigate a worker's comp claim. He is very knowledgeable his explanation of the process in layman's terms made it seem less daunting. I was so appreciative!"
Industry News
The Workers' Compensation Insurance Rating Bureau (WCIRB) has approved the recommended increase in hourly wage thresholds for all 16 construction dual wage classifications. The increases range from $2 to $5 depending on the classification and will go into effect for policyholders renewing September 1, 2022 and thereafter. The chart below outlines the increases for each classification.
Author, Drew Garcia, Vice President, Landscape Group, Rancho Mesa Insurance Services, Inc.
The year 2025 will mark my 10th year working with landscape, lawn care and tree care professionals across the country. This long-term approach allows our team the time to learn and grow with the industry. Being able to understand landscape operations and accurately relay this information to the insurance carriers is a critical component to the overall insurance program we put together for our clients.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
A growing thorn in employers’ sides has been the rise of worker’s compensation cumulative trauma (CT) claims. Cumulative trauma refers to the ongoing psychological and physical injuries that accumulate over time, often resulting from repetitive stress or exposure to adverse conditions. Employees missing time can lead to larger workers’ compensation claims, lower moral and less efficiency. It can be easy as an employer to take a defensive stance and fight every one of these but there are a few factors that need to be taken into consideration prior to deciding if you should settle or challenge these claims.
Author, Greg Garcia, Account Executive, Rancho Mesa Insurance Services, Inc.
There are three major benchmarks that all landscape companies should consider when looking at how well they manage risk: average claim cost, claim indemnity rate, and claim frequency rate. Knowing the importance of this, we designed a key performance indicator (KPI) dashboard that highlights these industry benchmarks, as well as benchmarks them against other landscape companies in their geographic area.
Author, Drew Garcia, Vice President, Landscape Group, Rancho Mesa Insurance Services, Inc.
Landscape business leaders can now provide their management team with resources to better support their workers’ compensation program. Rancho Mesa offers its landscape, lawn care and tree care customers an industry specific Workers’ Compensation Key Performance Indicator (KPI) that can be used to help benchmark a company’s experience modification rate (i.e., Ex-Mod, Experience Mod), and the underlying performance trends that can help stakeholders stay informed.
Author, Greg Garcia, Account Executive, Rancho Mesa Insurance Services, Inc.
Imagine you are a landscaping company owner and your workers’ compensation policy just renewed January 1st. You are probably thinking, now what? Well, the next date that should be on your radar is June 30th, your unit stat date.
The California Insurance Commissioner Lara has approved an increase in hourly wage thresholds for all 16 construction dual-wage classifications.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
How do you handle the situation when a great employee is injured but not quite ready to return to full duty? We do all that we can to prevent injuries and make sure once they do happen our employees are taken care of quickly and properly. The one true variable we have in our control, after a claim has been filed, is how to accommodate employees that are injured but not able to return to normal duties until deemed fully recovered.
Author, Drew Garcia, Vice President of the Landscape Group, Rancho Mesa Insurance Services, Inc.
Economies of scale create leverage for landscape businesses as they grow. The Bureau of Labor Statistics (BLS) 2022 table of incident rates notes that the landscape industry has an incident rate of 3.4 per 100 full time employees. Landscape is classified by BLS under Administrative and Support and Waste Management and Remediation Services; this sub class has an incident rate of 1.9. The average for all other industries is 3.0.
Author, Sam Clayton, Vice President, Construction Group, Rancho Mesa Insurance Services, Inc.
Earlier this month, the Workers’ Compensation Insurance Rating Bureau (WCIRB) recommended a nominal .9% increase in the advisory pure premium rates. The reason given, increased loss development for medical costs and higher claims adjustment expenses. This recommendation is now sent to the California’s Insurance Commissioner Ricardo Lara for approval. If approved, the increase in rates then take effect September 1, 2024.
Author, Matt Gorham, Account executive, Rancho Mesa Insurance Services, Inc.
In an effort to keep up with wage inflation, California’s Workers’ Compensation Insurance Rating Bureau (WCIRB) has recommended increases to all 16 construction dual wage thresholds, which, if approved, would impact policies beginning on September 1, 2024 and could drive up insurance premiums for those unaware.
Author, Megan Lockhart, Client Communications Coordinator, Rancho Mesa Insurance Services, Inc.
Recently, the State of California has made several important updates to labor pamphlets that must be provided to employees.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
One of the biggest ongoing challenges in the construction industry today is hiring and retaining quality employees that can help build on a company’s foundation. Growing a construction company in a sustainable way through internal promotions while also integrating new hires can separate one company from its competitors.
Author, Greg Garcia, Account Executive, Rancho Mesa Insurance Services, Inc.
Every business owner understands the correlation between their Experience MOD (XMOD) and what they will pay in workers’ compensation premiums. When the XMOD increases, there is a good chance that the workers’ compensation rates or premiums will rise as well. This is why it is so crucial to really hone in on company safety procedures to limit work-related injuries as much as possible. The reality is that even the safest company that does everything the right way is going to run into a workers’ compensation claim from time to time.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
Every year, OSHA publishes a “top 10 most frequently cited standards” list. Without question, ladders and fall protection consistently make the list. A Liberty Mutual 2023 workplace survey found that $6.26 billion was spent on falls as a result of working at height. Working at height is inherently dangerous but becomes more so when the incorrect ladders are used or improper setup for a job. Sending your employees to a jobsite without conducting a proper analysis to guarantee you have the proper equipment is setting yourself up to have preventable claims.
The Workers' Compensation Insurance Rating Bureau (WCIRB) has proposed an increase in hourly wage thresholds for all 16 construction dual-wage classifications.
The increases range from $1 to $4 depending on the classification and if approved will go into effect for policyholders renewing September 1, 2024 and thereafter. The chart below outlines the proposed increases for each classification.
Author, Greg Garcia, Account Executive, Rancho Mesa Insurance Services, Inc.
One of the most important practices for any landscape professional is fleet safety. Whether you have 10 trucks or 100, the exposure and risk remain the same. Explore a prior podcast episode, Episode #251, in which I delve into compelling statistics that shed light on the increasing frequency and severity of auto accidents each year.
Author, Greg Garcia, Account Executive, Rancho Mesa Insurance Services, Inc.
When my baseball career ended in 2021, it was time for me to do something new with my life. For me the decision was easy and one that I am very grateful for. My dad, Dave Garcia started Rancho Mesa 25 years ago and throughout the years he and many others have contributed into what Rancho Mesa is today, a 16-time National Best Practices Agency. I was fortunate enough to get an opportunity to join such an amazing organization.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
With unemployment rates settling near 4 percent, it is becoming increasingly difficult to find the right employees to help grow your construction company. With most able-bodied workers having secure employment, this leads to having either apprentice-type employees that come with unique challenges or pulling from an aging workforce that can bring cumulative injuries and risks. Navigating these issues can be complex and there is not a perfect solution, but employer’s hiring practices need to change in order to keep up with the current state of the industry.
Author, Sam Brown, Account Executive, Rancho Mesa Insurance Services, Inc.
As some company leaders may recall, since 1991, all California employers are required to maintain a written Injury and Illness Prevention Program (IIPP). An IIPP is an understandable and accessible safety program tailored to a business’ operations. An effective IIPP will help an employer establish and maintain a safe workplace while setting expectations and protocols for all employees.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
For many foremen and superintendents, weekly tailgate meetings can feel like a task that just needs to be checked off the list. However, while the purpose of these meetings is critical for the health and well-being of fellow field employees, the time required and repetitive nature of them can create challenges. To maximize the benefits of these meetings, construction firms must be proactive and thoughtful as they develop an inventory of topics.
Author, Sam Brown, Account Executive, Rancho Mesa Insurance Services, Inc.
As non-profits and leaders of human service organizations navigate important business decisions in the face of inflation, it’s important to consider measures that can reduce inflation’s impact to an organization’s operating budget. Today, we look at inflation’s effect on workers’ compensation insurance and strategies to reduce future costs.
Author, Megan Lockhart, Media Communications and Client Services Coordinator, Rancho Mesa Insurance Services, Inc.
As businesses ring in the New Year, it is important for owners to note some key changes to state and local wage policies taking effect January 1, 2023.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
With the heightened safety regulations and OSHA guidelines over the past decade, many would think we are working in a much safer environment with fewer fatalities. Despite the rising number of employees and using a standard based off deaths per 100,000 employees, the data is showing that the number of fatalities are the same as they were a decade ago.
Author, Rory Anderson, Account Executive, Rancho Mesa Insurance Services, Inc.
Within the last few weeks, all licensed tree care companies received a notice in the mail from the California State License Board (CSLB) stating that effective January 1, 2023, the CSLB is requiring that all companies with a D-49 Tree Service Contractor license must have workers’ compensation insurance, regardless of whether they have employees.
Author, Sam Brown, Account Executive, Rancho Mesa Insurance Services, Inc.
California employers work hard to maintain a safe workplace, but accidents and injuries can occur. While human resources professionals typically have an excellent understanding of the workers’ compensation claim process, proper supervisor training can improve workers’ compensation outcomes for employers and their injured workers.
Author, Jim Malone, Workers’ Compensation Claims Advocate, Rancho Mesa Insurance Services, Inc.
There are many things the employer is required to do after a work related injury occurs. There are also additional things an employer can and should do after an employee is injured, though not required by any regulatory agency, like offering modified work.
Author, Kevin Howard, Account Executive, Rancho Mesa Insurance Services, Inc.
There is a lot at stake for roofing contractors in California. Many of us recall playing the game “would you rather” as kids. Would you rather jump into a freezing cold pool in December or eat the world’s hottest chili pepper with no milk available?
Author, Rory Anderson, Account Executive, Rancho Mesa Insurance Services, Inc.
Pure premium rates are determined by the Workers’ Compensation Insurance Rating Bureau (WCIRB). The rates reflect the amount of losses that an insurance carrier can expect to pay out in claims for that particular class of business. Every year, the WCIRB submits pure premium rates to the California Department of Insurance for approval. These pure premium rates are comprised of loss and payroll data submitted to the WCIRB by all the insurance companies in California.
Author, Casey Craig, Account Executive, Rancho Mesa Insurance Services, Inc.
One of the biggest concerns for contractors is their Experience Modification Rating (EMR). If your EMR exceeds 1.00 or 1.25, contractors can be removed from bid lists and premiums can escalate quickly. Most decision makers have little idea what factors contribute to the EMR and just how claims can impact them.