In-House Claims Administration
Manage Claims:
NYSIF workers' compensation policyholders may electronically submit a workplace injury report to NYSIF 24/7 with NYSIF eFROI.
- Provides the reporting party a loss record identification number (also known as a claim number), immediately after submitting the NYSIF eFROI report.
- Allows for immediate loss record created with the eC-2 information provided by the policyholder.
- Allows for quick accident investigation and proactive management of the claim.
- Reduces errors in reporting and allows us to control claims costs.
Ensure that the carrier is taking the necessary steps mentioned below:
- Investigate fraudulent claims and review for denial.
- Set up Independent Medical Examinations for cases involving awards and/or excessive.
- medical treatment.
- Treatment is within Medical Treatment Guidelines.
- Review claims for subrogation offsets.
- Review claims for settlements and classification to control costs.
Review Loss Runs:
Prior and current loss runs will be reviewed for the purposes mentioned below:
- Identify claims to be reviewed for reserve reductions.
- Make sure loss information on Loss Runs correspond with information at eIRB.
- Identify claims to be retired.
Monitoring Progress:
The client will be provided with claims status reports when applicable. These reports will include the following information:
- Accident details and injury sites.
- Medical treatment.
- Reserves.
- IME.
- Hearings.
- Plan of Resolution.