The Importance of Cooperation in Workers Comp Investigations

Here’s why cooperating during a workers compensation investigation is so vital.

If an employee is injured or becomes ill on the job, then they will likely file a workers compensation insurance claim.  Not only is it important to report this claim in a timely manner, but it is also important that you assist the claims adjuster in any way possible.  Not only will your collaborative efforts facilitate the progress of a claims investigation, but it can even help the adjuster identify a possible third-party.  Here are some of the things you can do to assist with a claims investigation.

  • Require supervisor reports that record the initial details of the incident. This will help you capture details immediately before information is potentially lost or changed over time.
  • Help the adjuster gather the written and verbal witness statements as needed.
  • Help coordinate communication between the adjuster and the injured worker. For instance, you can organize meetings between the two and give the adjuster the employee’s contact information.  You can also do this if the adjuster needs to speak to supervisors, witnesses, coworkers, and anyone else involved in the claim.
  • Inform the adjuster about any concerns or issues you may have. Something that may seem insignificant at the outset could potentially have a huge impact on the outcome of the claim.

In addition to these things, you can also help the adjuster identify third-party involvement.  Here are some of the things you can do:

  • Scene preservation– If a product defect or machine malfunction is suspected, then it’s important to work with the adjuster to decide if the machine needs to be removed from production to allow for further investigation.
  • Taking pictures– Pictures play an important role in the evaluation of subrogation. Pictures help preserve the scene and can help make the difference in a successful recovery from a third party.
  • Sharing information– Finally, sharing police reports, contracts, and other documents with the adjuster can be important in the evaluation of subrogation. Contractual agreements may need to be reviewed to determine if there was a duty owned/breached.

These are some of the ways you can cooperate during a workers comp claims investigation.  Do you have further questions regarding your business’s workers compensation insurance?  Then turn to the experts at PMC Insurance Group.  Contact us today to learn more about getting competitive coverage for your small business clients.

By PMC Insurance Group

Since 1996, PMC Insurance Group has worked to help independent agents grow their client base by offering workers' compensation solutions for a wide array of businesses. As one of the most distinguished workers' compensation wholesalers in the country, we have the tools and resources to help you create coverage programs for both small businesses and large accounts.