Presented by Toste Insurance Services

Workers’ Compensation

Reducing risk and cost

Quick Introduction

Thank you for considering Toste Insurance Services, Inc. as the broker for your company.

Our staff of trained professionals includes individuals who have the necessary professional training and skills needed to carry out the required claims management services for your company.

For more information please visit: www.tosteins.com

What We Strive For

Employer Service Objectives• Provide services focused on

reducing the frequency and severity of workplace injury

• Communicate with key decision makers to create an effective safety and claims management plan

• Establish and maintain good working relationships with adjusters

• Provide Workers’ Compensation quarterly status reports

• Modification Score Projection

“By definition workers comp adjusters have a loyalty to the injured worker and no one else. My loyalty is to our insured and making sure the claims are handled as quickly and cost efficiently as possible.”

- Kara Keene, Work Comp Claims Manager

Toste Insurance Services

The Process

INJURY

Send IW (injured worker) for treatment within your Medical

Network

Promptly fill out claim form 5020 and DWC1

SUBMISSION

Send claim forms into the carrier or TPA (Third

party administrator)

Adjuster is assigned and claim is reviewed for any

red flags or disputes

OUR SERVICEFollow up on all open claims for quick closure

Push for lower reserves, argue unnecessary

treatments

OBJECTIVES Manage claims Modification Score Reduction

Status Reports

A Summary of what you can expect to receive

A break down of how claims are affecting your premium.

Multiple year review of premium cost vs claim cost

A chart of total claims vs open claims over a multiple year span

A great analysis of your injuries.

What class codes are having the most injuries?

What body parts are most affected?

You can easily see that class code 9008 has the most claims.

The lower back and ankles have the highest percentage of injury… why?

The nature of a claim is important, but the cause will help you fix it.

Here you’ll be able to identify the biggest cause for injury.

Slip & Fall and Lifting are the two largest portions.

Take a quick look at your employee footwear and lifting techniques.

Mod Trending: a prediction for your mod score over several years based on current data

Summary of open claims

Your primary losses ($7,000 and below)Actual cost, expected cost, and managed cost

Excess losses are losses that are $7,001 and greater

A quick run down on premium percent to payroll percent over five years

Premium per class code over five years

All of this information goes into calculating your mod score

Claims Management

The Toste Way

• SB899 Reform

• SB863 legislative changes

• X-Mod analysis and control

• Medical cost inflation

• Increase in cost containment factors

• Legislative changes

• Increasing litigation

• Turnover in claims examiners

Why Do You Need Claims Management?

Toste Insurance Services understands the impact of Workers’ Compensation claims on business and the need to control escalating Workers’ Compensation costs. That is why we specialize in comprehensive claims management solutions.

Litigation

Medical

Disability

Why Toste Insurance Services?

The nature of Workers’ Compensation encompasses risk.  The ever-changing laws, standards and regulations make proper education imperative in sustaining low claim frequency and severity.

Our staff has extensive training and experience. What are other brokers doing to stay ahead?