Injury Management

Teresa Long, CWCA

Injury Management Coordinator

Teresa’s experience includes 14 years as Workers’ Compensation Claims Manager for Walt Disney World and most recently Vice President of Risk Management for Sarasota, FL-based Unisource Administrators, Inc., managing general agent and third party administrator, where she was responsible for client services for all professional employee organizations, large deductible and self-insured clients and product development. She was also vice president of Sarasota International Risk & Insurance Services (SIRIS, a third party claim administrator for self-insured and large deductible clients), a subsidiary of RISCORP, a Florida domiciled insurance company.

Teresa was also instrumental in the founding of the Association of Workers’ Compensations Claims Professionals (WCCP) and a Board Member and regular speaker for the Florida Workers’ Compensation Institute for over 20 years

Results for one month:

Closed:  1 injury

Closed with reserve reduced by $81,884.  

• New:  No new claims were reported this month

Medical Only Claims

• Previously Open:  No previously open claims
• Closed:  No claims were closed this month
• New:  No new claims reported this month

Total Incurred:    $56,361.37 decreased $81,884 this month

Average Incurred:  $9,393.56 decreased by $13,647.36 this month

Each month each client receives a detailed report of activities.

Steve Tade, MWCA

Email to Steve Tade MWCA

Good news, no GREAT news!!!   I just got a call from the adjuster at XXXXXXX and she told me the Contribution is all about getting 50% of the total medical paid back from the insurance company. This happened at a hearing on 10/20/14 and they have 14 days to pay up (11/3/14).  She said they did not settle the claim with the injured worker and his physician gave him a two percent rating which is the same rating he previously received so there were no benefits due.

She said at first injured employee did not understand this but when she further explained had the physician gave him even a three percent rating, he would have only received the difference of one percent but as it was the same as before (two percent) there were no benefits due.  I like this law!!!

So next I asked her why there was such a big outstanding reserve and she didn’t know and agreed to reduce it to a big ZERO right then.  This means the $63,207 is now a zero and the Total Incurred just went from $89,764 to $26,557 and within the next 10 days will further be reduced to a Total Incurred of only $13,278.50!!!  and the claim will be closed as soon as she gets in the final defense attorney bill (paid as expense and not included in the mod) which will be for sure within the next 30 days.

Bottom line – by (no later) than the end of November, this claim will have gone from $89,764 to $13,279 a reduction of $76,485!   YEAH!!!!!  AND – all of your claims will now be CLOSED!!!

I just love to send emails like this.  I’ll wrap up the month end reports with this new information and be sending them out in a few minutes.

Jim Diffenderfer

Director of Safety and Loss Control Services

Jim teams with employers to plan, implement, and coordinate safety programs to prevent or correct unsafe working conditions. Jim also coordinates the various insurance company services that are available, as well as any employer safety-related needs.

Jim is also a resource available to review insurance company safety recommendations, OSHA interaction, and new safety regulations that pop up, so employers are prepared as they become effective.

With 40 years experience as a safety professional with Anheuser -Busch and Continental Baking, plus as a safety consultant with Marsh Companies and Missouri Employers Mutual, Jim’s varied experience “leaves no stone unturned.”