WORKERS COMPENSATION CLAIMS MANAGEMENT SOFTWARE || BUILD OR BUY in 2021?

Updated: Jun 21

It is a fact that out of the entire data that is present in this world, about 90% of it has been produced in the last 2-3 years. And we have had digital data since the 20th Century. What it indicates is an exponential rise in the production of data in the last few years.

It implies that we now heavily rely on the internet to access that data. The Internet is where Cloud comes in and on cloud is where all great organizations and businesses thrive nowadays.

The insurance industry is no exception. As a result, it now uses software that helps it run its operations online with large amounts of data. And this brings us to our topic for today.

Where does software fit in the context of Workers’ Compensation? But before we get to discuss the workers compensation claims management software, we need to check some boxes.


Table of Contents

  1. - Introduction

  2. - Workers’ Compensation

  3. - Workers’ Compensation Claims

  4. - Workers’ Compensation Claims Adjuster

  5. - Workers’ Compensation Insurance

  6. - Workers’ Compensation Insurance, Florida

  7. - L&I

  8. - ISO

  9. - Claims Management Software

  10. - What Is Claims Management Software?

  11. - Buy or Build?

  12. - Workers Compensation Claims Management Software

  13. - Workers Compensation Claims Management Software, Pennsylvania

  14. - Feature of Workers Comp Claims Management Software

  15. -Tracking

  16. -Documentation

  17. -Management of Medical Things

  18. -Automation

  19. -Increase Productivity

  20. -Cost Management

  21. - List of Workers Comp Claims Management Software

  22. -Free Workers Comp Claims Management Software

  23. - FAQs

Introduction


workers compensation claims
workers compensation claims


Workers’ Compensation


workers compensation insurance
workers compensation insurance

The term, Workers’ Compensation, in itself, is enough to dish the dirt on its meaning. It is suggesting that there is some sort of compensation for the workers.

But what workers? And what compensation?

Both these words- workers and compensation- can be used in different contexts and as a result, they could mean something open to interpretation. But in this article, the term Workers’ Compensation, means something a lot more specific.

So, let us establish the context in which the two constituting terms have been used. Workers mean people who are employees on a payroll for a certain employer and Compensation means the replacement wages that they will receive.

But replacement wages for what?

The worker will get replacement wages for the time during which he is unable to come to work. And why he is unable to come to work will bring us to the Workers’ Compensation Claim.


Workers’ Compensation Claims


workers compensation injury form
workers compensation injury form

Let us consider a scenario in which the said worker has been severely injured or picked up an illness while he was at his workplace or during his duty hours. And this injury or illness is physically keeping him from coming to work anymore.

Under normal circumstances, if an employee is not coming to work then the employer has every right to deduct a portion of his wages but in this case, the employee is protected by his right to file a Workers’ Compensation Claim.

If an employee sustains an affliction while carrying out his employment duties and he is unable to come to his workplace anymore then he can still avail his wages by filing for a Workers’ Compensation Claim.

The workers’ compensation covers everything from wages and the cost of medical bills to disability and death benefits.


Workers’ Compensation Claims adjuster


workers compensation claims management software to aid claims adjuster
workers compensation claims management software to aid claims adjuster

He is the person who decides how much money a workers’ compensation claimant will receive as compensation for his liabilities due to his misfortunes while carrying out his employment duties or if he will receive it at all. He tries to put the best interests of the insurance company, the employer, and of course the employee in alignment.


Workers’ Compensation Insurance


workers compensation claim application
workers compensation claim application

Workers’ Compensation Insurance is the insurance that needs to be purchased by employers who run or operate a business with employees on their payroll. In most states, employers are obligated legally to purchase this insurance.

Workers’ Compensation Insurance is purchased so that the employer can cover the expenses that will occur when any Workers’ Compensation Claim gets filed. A Workers’ Compensation settlement can be very expensive for insurers and employers.


Workers’ Compensation Insurance, Florida

Florida is one of those states that requires most employers to purchase Workers’ Compensation Insurance. This gives the employees the ability to work with fearlessness and the employers, the immunity from any lawsuits from their injured employees.


L&I

The Washington State Department of Labor and Industries is an insurance for the employees working in Washington state that covers for their workplace injuries and occupational illness. It covers replacement wages, medical bills, any type of disability, rehabilitation, travel expenses, death benefits, loss of earning power, etc.

It can be individually purchased or your employer can have it purchased and a worker can file for L&I compensation in case he gets injured at work.

The most important difference is that, if someone is a worker in Washington state, then he is automatically covered by L&I, with some minor exceptions. You do not necessarily need to pay for this insurance. That is not the case with Workers’ Compensation. You or your employer needs to have a Workers’ Compensation Insurance to file for a Workers’ Compensation Claim.


Insurance Services Office (ISO)


claims adjuster for workers compensation claims
claims adjuster for workers compensation claims

The reason why Insurance Services Offices exist is so that they can collect and analyze data of insurance companies to provide them with an ISO report.

What is the need for an ISO report and why do insurance companies need it?

And the answer is quite simple – to avoid unnecessary financial losses.

The data in these ISO reports is an analysis of the raw data that they received from insurance companies. The data can include things like records of all the entities -individuals and organizations - that have purchased insurance from them, the financial statements of all the people that have claimed any insurance money from them, the reason for claiming the insurance money and of course the details of those people.

This data is further refined to produce results that help these insurance companies take effective cost control measures. The interpretation of this data helps them drive the costs associated with Workers’ Compensation Claims



Let’s say a person gets injured at his workplace and becomes involved in a Workers’ Compensation Claim. In this case, all the details about this person’s Workers’ Compensation Claims will be provided to an ISO. This data can then be used in the future by that insurance company if something similar happens again.

The ISO reports that the Insurance Services Offices provide to the insurance company is very important in cases of false Workers’ Compensation Claims. There have been instances in the past where people have committed multiple Workers’ Compensation Claims fraud multiple times and for years.

Now it has become a standard practice to take into consideration a claimant’s past Workers’ Compensation Claim record and detect and prevent these frauds. And you guessed it. The ISOs are the ones keeping track of the injury records of the injured workers.


Workers' Compensation Claims Management Software