By Donna Motley, Vice President of Claims

There are a lot of advantages to have your Workers’ Compensation insurance with MTMIC, but I want to point out a few that are “hidden” advantages.

As mentioned before, our Claims staff has extensive years of experience handling Workers’ Compensation claims. I would like to say we have “seen it all”, but every once in a while a situation will occur that is a “first”, even for us. Most of the Claims staff has extensive years of service AT MTM. For many, many years our core business focused on the manufacturing and tooling industry. And because of our company’s longevity in this industry, we have some insureds that have been with us since the early days. You might wonder, where is the advantage in that? Well, the first thing we do when a claim is received in our office, is check to see whether or not the injured worker is already in our claims system. If an employee incurred an injury between 1976 and 2017, and a claim was submitted, we have record of it in our system. We ask injured workers if they sustained any previous work injuries, and if they say no, but we find them in our system, that’s a red flag that may raise the question “what are they trying to hide”? We sometimes see patterns forming – say, an injury every hunting season. Or recurrent injury to the same body part which might mean the job site or process should be adjusted.

If an injured worker sustained a previous work injury, there is a very good chance the same adjuster will be assigned to the new injury. That may make the injured worker feel a little less stressful or less defensive, because they are already familiar with the adjuster, our procedures and know what is expected of them. If an employee tried to “malinger” on a previous claim, or had difficulty attending appointments, or co-morbidities that showed up in medical records that had an impact on recovery, we know that as well and can adjust treatment accordingly.

We keep the number of claims assigned to each adjuster manageable so the adjuster can be familiar with each file. Should a claim turn litigated, the adjuster knows minute details of the claim. We utilize attorneys that have longevity with us as well – they know how we operate. We direct the attorney – we don’t just turn the file over to them for handling – the adjuster is still very involved in the case. Our adjusters will attend Facilitations – which most Magistrates appreciate because they feel the insurance carrier is not just “pushing paper” or trying to “make a deal”. (Not to mention, WE hold the purse strings.) Attending court hearings also gives us an opportunity to see how our attorney operates in Court. Attending keeps our name (MTMIC) and face before the Magistrate. In a recent case, Sr. Adjuster Cindy Boyce attended a Facilitation on a case where the settlement demand was $105,000; there was a $35,000 chiropractor bill. With Cindy in attendance, she was able to talk directly to the Magistrate and voice her opinion and concerns, argue our point and bring up many of the small details that can make or break a case. The ultimate result – the case is being settled for $13,500, inclusive. Would the result have been the same had she not been there – I don’t know, but we at least know the settlement was made based on fact and not necessarily a compromise simply to move the docket. The plaintiff’s attorney is no longer able to use delay tactics in hopes of obtaining a higher settlement. Remember, plaintiff’s attorneys are paid a percent of the settlement.

Another advantage of our longevity in this industry, is that the Magistrates know us, as do many plaintiff’s attorneys. They know we don’t just “roll over” and take the easy way out. There are a couple of current Magistrates that previously worked for firms that handle our cases. One of the attorneys we utilize started as a law clerk for the Appellate Commission so he knows how the Commission thinks and operates – not a bad person to have on your side! All litigated cases are postured for Appeal as well as settlement. In any litigated case, we do not pay without proof.

Not to criticize other insurance carriers, but all we handle is Workers’ Compensation. You might say we specialize. We will visit our insured’s location and view the operations, we attend Facilitations and Trials, we attend legal conferences to obtain recent changes in the law. We do our best to have a close working relationship with occupational clinics and medical providers. We utilize experienced, knowledgeable Nurse Case Managers and Attorneys. (We have pulled a case from an attorney when we felt they were not obtaining the best results.) When necessary, we hire investigators and work closely with them to obtain results that aid our case. I’m not sure all Workers’ Compensation carriers can say the same. Most of all, we are always available to answer questions, aid your injured employee to successfully return to work and, ultimately, save you money!