Case History 5

The Claims Management Reality

 CASE HISTORY # 5

CLIENT:  DAIRY PRODUCTION COMPANY

CLAIM:    INJURED BACK

Claimant injures back while unloading a truck at a delivery site.

Upon review of the medical bills, we discovered that the claimant received daily diathermy and hydroculation treatments for a period of two weeks, including Saturdays.

Examination of these and other reports from this particular treating physician revealed a high incidence of back claims with repetitive treatments for extended periods of time. We alerted the client to the physician’s mode of treatment, and recommended that his visits be monitored more closely.

On our recommendation, the client informed the carrier that this claim was submitted in error.

BENEFIT: Client’s reserves will be lowered, thereby reducing their experience mod and the premium.