Claims Management Services
The Trust takes full responsibility for the cost of all losses such as payments to medical providers for examinations, medical treatments, hospital stays, surgery, rehabilitation services, and other types of workers’ compensation losses that might be sustained — as well as the cost of lost wages (indemnity payments) to injured employees. When warranted, The Trust may utilize other value-added services to aid in managing its Member's workers' compensation claim.
The Trust is committed to working closely with its Members to ensure the legitimacy of each and every claim. Although studies show that only 1%-2% of workers’ compensation claims are actually fraudulent, The Trust routinely investigates workers’ compensation claims for such abuse, including the use of surveillance and other investigate tools when warranted.
Nurse Case Management
Use of nurse case management services in certain medically complicated workers’ compensation claims can often significantly reduce the duration and cost of a claim by guiding injured workers’ medical treatment and return to work efforts. The role of the nurse case manager, is to facilitate workers’ comp claims by advocating for the injured worker’s medical needs and providing a continuous flow of communication between all interested parties and the medical provider.