“TeamCOMP”: An inside look at how the Insurance Companies view your work-related injuries
By Michael Gorny, Esq.
When a worker in New Jersey is injured during the course of their employment, they are generally entitled to three types of benefits. These benefits include medical treatment, temporary disability payments, and permanency benefits. Employers in New Jersey are obligated to either carry approved insurance coverage to ensure their workers receive such benefits or to register with the state to prove they have enough assets to self-insure for such benefits.
Once such claims are made, the employer generally hands off the injured employee to insurance carriers or claims services. As expected, these insurance entities are usually driven to bring down insurance costs and increase profitability. There are only two ways to accomplish these goals: by raising insurance rates or by lowering the costs of providing benefits on workers’ compensation claims. Of course, to keep their clients happy, these services try to limit the benefits provided to injured workers.
A prime example of such an approach can be found in the announcement by Avizent, a national claims service provider, of their “TeamCOMP” approach to claims services. One just needs to read their description of their product to understand their goals of limiting benefits to injured workers. "Our approach ensures that claims and medical expertise are applied precisely when and where they're needed," notes Thomas W. Watson, Avizent's Chief Executive Officer. "Claims outcomes become more predictable. Treatment and disability planning improves. Costs are easier to manage and control.”
"In the traditional approach to medical management, nurses or medical experts are brought into the process late, which means medical information critical to the claim may be unrecognized, diluted, or lost," explains Doug Markham, Executive Vice President of Avizent's Managed Care Service division. "In addition, the nurses and case managers often work for an organization other than the claims management provider, and may not share the same level of commitment to the client's goals."
As an injured worker in New Jersey, it is ever-increasingly important to have an experienced workers’ compensation attorney guide you through the process, to ensure that you receive all of the benefits that you are entitled. Without an attorney, you run the risk of becoming a cost-cutting measure that the insurance companies desperately seek to drive up their profit margins.
Contact us today to review your rights with a NJ Workers Compensation Attorney. Call for your workers comp free consultation 800-709-1131.