Frequently Asked Questions - FAQs
CUSTOMER SERVICE
Q. Who handles policy questions
for customers?
A. Each
policyholder is assigned a customer service account manager, who
can assist with your questions and needs.
Meet
the Customer Service team.
CLAIMS
Q. Why is Employers Direct's
Claims Department different?
A. Employers Direct
Insurance Company partners with our policyholders, injured
workers, and the medical community to provide superior claims
service.
Reasons Why Our Superior Claims Services Are Possible:
- Low Case Loads: We give our Claims Examiners the time to address all of the issues on your files. Our maximum caseload is 125 files.
- Experience: Our Claims Examiners average 10 years experience and are among the best in the business. State certification levels are among the highest in the industry.
- Training: Laws and regulations can change daily, weekly, or monthly. We provide on-going and timely training and direction as things change to ensure that Employers Direct takes advantage of all possible savings for our policyholders – and our team is well versed in all aspects of SB 899.
- Consistency: Employers Direct has a detailed policy and procedure manual and published workflow to ensure that best case practices are utilized.
- Aggressive Claims Handling: We fight appropriate claims and liens, often spending Employers Direct’s dollars to save policyholders’ loss costs.
- Supervisor Oversight: Our supervisors do not carry caseloads. They triage, monitor, and provide additional direction to your Claims Examiner to ensure that the best results are achieved.
- Fraud and Investigation: Employers Direct partners with our policyholders to investigate all suspicious claims and takes action to eliminate or minimize claims. In addition, Employers Direct has a confidential toll-free hotline for reporting suspected fraud: 866.SIU.EDIC (866.748.3342).
- Medical Provider Network (MPN) Compliance: 100% of our policyholders are enrolled in our Medical Provider Network, which allows lifetime medical control over claims.
- Policyholder’s Claims &Information Center (PCIC): Our secure online portal provides real-time access to claims reports, loss runs, and policy data 24/7 at the click of a mouse.
- Clerical Support: Workers’ compensation is labor
intensive and time sensitive. Our philosophy is to
provide appropriate clerical support to meet all statutory
requirements and allow the Claims Examiners time to
concentrate on resolving the issues. This approach saves you
money.
For more details, visit Claims.
Q. How can Employers Direct help my company
if I suspect fraud?
A.
Employers Direct partners with policyholders to investigate all
suspicious claims and maintains strict procedures when
investigating fraud and abuse. All lost time claims are indexed
for prior claims, and the investigation process is integrated
with claims. Employers Direct informs policyholders at every
step, and questionable claims are denied. Claimants, applicant
attorneys, and medical providers who attempt to defraud the
system are turned over to law enforcement for prosecution.
Q. What is the benefit of Medical Provider
Network (MPN) compliance?
A.
All published studies have proven that physicians versed in
occupational medicine:
- Provide more accurate treatment for industrial injuries
- Result in less temporary disability days
- Lower litigation rates
- Result in less permanent disability
Q. What is the
Policyholder’s Claims & Information Center (PCIC)?
A. Employers Direct takes advantage of
the latest technology in the claims handling process to provide
policyholders with secure online access to claims and policy
information 24/7.
- PCIC provides control: up-to-date and extensive claims and policy information
- PCIC provides time/cost savings: elimination of the need for most phone inquiries and call backs
- PCIC provides convenience: electronic day-to-day interaction between you and Employers Direct
- PCIC provides real-time information: secure online access to claims, loss runs, and policy information in real time, 24/7
LOSS CONTROL
Q.
What is the purpose of Employers Direct’s initial Loss Control
Survey?
A. Before providing a
quote for workers’ comp insurance, Employers Direct conducts a
loss control survey. This allows your company to share details about operations that may impact
safety. This information is valuable for our underwriting
department when preparing a quote. This is also the time
for us to share areas of concern that can help your business
immediately.
Q. How can Employers Direct
help my company to reduce losses?
A.
Before problems can be solved, they must be thoroughly
understood. Employers Direct will work with you as a team to
pinpoint where and how problems occur.
Q.
How experienced are Employers Direct’s loss control team?
A. Employers Direct’s loss control team
is comprised of talented individuals who average 20 years of
experience, and all are OSHA-certified in General Industry
Safety and Health as well as Construction Safety and Health.
Q. Will Employers Direct train my company’s
employees?
A. An effective
safety program requires motivated and trained personnel.
Employers Direct focuses on “Train the Trainer” and provides the
tools to train and supervise your employees safely.
LEGISLATIVE RELATIONS
Q. How
can I contact Mark Webb or suggest editorial topics?
A. Visit
Contact Mark.
Q. How can I read Mark's Editorials?
A.
Visit Mark’s Editorial page.
Q. How can I hear Mark speak in person?
A.
Visit Speaking Engagements.
Q. How can I find my
legislator?
A. Visit
Find My Legislator.
Q. What are
the best practices to control workers’ compensation insurance
costs?
A. Visit
Best Practices.
