Handling claims expertly is our claim to fame.
Accidents happen. But effective claims management is the result of years of experience, ongoing professional training, the highest state certification levels, rigorous best practices and a company that dedicates the time and resources required to make sure every claim is handled thoroughly and efficiently.
Our claims management team is one of the best in the business. With an average of 10 or more years of experience, our staff members are seasoned pros who understand the laws as well as rules, regulations, procedures and pitfalls. They apply that knowledge to put into action the very best strategies to keep claims from spiraling out of control.
In-house and California-based. Some carriers outsource their claims to companies that may be out of state. Our claims management team is not only accessible,they’re highly knowledgeable about workers’ comp issues highly specific to California. They offer prompt three-point contact so everyone—broker, employer, injured worker—gets the immediate information and attention they need.
Manageable caseloads and a dedicated team. At PacificComp, we maintain a maximum caseload of 125 files, one of the lowest in the industry. They’ll know you and your business and be able to devote the time required to investigate every claim to achieve positive resolutions.
24/7 claims reporting and status updates. You or your broker can report a claim at any time using our toll-free claims hotline. Our Policyholder’s Claims & Information Center (PCIC) gives you real-time, online access to your policy details and the status of any current claims.
We work hard to get workers back to work. We work with you and your broker or agent to develop early return-to-work plans that accommodate the employee’s health status and recovery. Claims with ongoing disability are reviewed and analyzed every day for expedited issue resolution. Returning employees to work is a key cost reducer for your claims as well as for your business. Our Medical Provider Network (MPN) includes occupational medicine providers, physician specialists, hospitals, surgery centers, and other ancillary providers. Their expertise means more accurate diagnoses and treatment, faster recovery and less permanent disability.
Control of claimant litigation leads to reduced overall costs. Our litigation management starts the moment a claim is reported. We respond quickly and treat workers respectfully, which immediately decreases the likelihood of a lawsuit. Our in-house counsel is a recognized authority on California workers’ comp insurance. Plus, we have developed aggressive agreed litigation programs with our litigation representatives to minimize cost and expedite resolution of issues. We also utilize subrogation identification and recovery plans to secure reimbursement when another party is responsible for your loss.
Zero tolerance for fraud and abuse. PacificComp has strict policies and procedures in place to detect, deter and defeat fraud. We investigate all claims and all lost time claims are indexed for prior claims. While keeping our policyholders and their brokers informed, questionable claims are denied, and claimants, applicant attorneys, and medical providers who attempt to defraud the system are turned over to law enforcement for prosecution.