Six Reasons for Promptly Reporting a Workers’ Compensation Claim

Author, Jeremy Hoolihan, Account Executive, Rancho Mesa Insurance Services, Inc.

 Construction worker holding neck in pain.

Reporting workers’ compensation claims in a timely manner can have a huge impact on the severity of the claim. Some policyholders believe the practice of not reporting employee injuries early is a good business practice. This could not be further from the truth. Below are six reasons why reporting claims early can reduce the overall impact of a claim on an employer’s insurance premiums:

  1. Lowers the cost of a claim – The cost of a claim gets higher and higher for each day it is not reported. Claims reported after 30 days of the injury on average cost 30% more than those reported right away.

  2. Ensures that key evidence is secured – The prompt reporting of a claim allows the claims adjuster to ensure key evidence is preserved. It also ensures that the supervisor’s accident report and witness statements are taken while things are still fresh in their minds.

  3. Potential hazards are identified as early as possible – When an injury or near miss occurs, there should be an accident investigation completed to find out the root cause of the injury. Identifying the cause or potential hazard will reduce the likelihood of a similar claim from occurring in the future. It can also be useful as a training topic during safety-related meetings.

  4. Could identify “red flags” for fraud – It is very important to understand that an insurance company only has 90 days from the employer’s (or their management or supervisors) date of knowledge to accept or deny a claim. If the claim is reported late, it leaves the adjuster little time to investigate the validity of a claim, which might force them to accept it. If the claim is reported 90 or more days after the date of knowledge, the adjuster has no choice but to accept the claim. The impact of a fraudulent claim can have a significant effect on future workers’ compensation pricing.

  5. Reduces litigation – When an injury claim is not reported in a timely manner by the employer, it can make the injured employee feel neglected or disgruntled. Reporting the claim early, showing compassion towards the employee, and keeping the lines of communication open will significantly reduce the likelihood of a litigated claim. Employees need to feel they are going to be taken care of medically and still have a job at the company. Employees are more likely to hire an attorney when they feel uneasy about their job security or they are not receiving proper treatment. When a claim becomes litigated, it typically prolongs the time it takes to close the claim and increases the cost by an average of 30%.

  6. Untreated medical only injuries could develop into indemnity claims – A small percentage of medical only claims can turn into indemnity claims as a result of unforeseen complications. For example, if an employee has a small metal shard stuck in their finger and chooses not to receive treatment, the finger could become infected, require surgery, and ultimately cause nerve damage. Had this injury been properly treated from the beginning, it likely would have simply been a first aid claim. Early treatment is key to minimizing indemnity claims.

Quickly reporting claims is simply one risk management strategy to controlling a business’s insurance costs. To discuss this strategy and others please feel free to contact Rancho Mesa Insurance at 619-937-0174.