Claims Management
Windley Ely advocates proactive cost effective claims management techniques including prompt and accurate processing of legitimate workers’ compensation claims, legislative compliance, penalty avoidance, early return to work, and claim cost management.
WE Claims Management Team
Claims Specialists are responsible for day to day claims activities including accident reporting, early and safe return to work, adjudication level appeals, application for cost relief, medical management of claims and the early and safe return to work process.
Account Managers are the primary customer contact. WE Account Managers provide direction, guidance and intervention in complex cases through mediation services and manage the complete account - encompassing reporting all accident costs, experience rating profiles, accident statistics, trends and costing.
Claims Intake Personnel are the WE front-line, receiving notification of workplace injuries and then gathering all necessary information to process accident reports and submit the employer’s reports of injury to the appropriate Board/Commission. These reports will also include letters outlining initial entitlement and return to work concerns in anticipation of potential forthcoming appeal issues.
Claims Management Staff are assigned to specific claims and will follow each claim from incident to resolution, including:
- Monitoring files for our customers
- Communicating concerns of entitlement, cost relief and return to work decisions
- Forwarding objection letters and/or complete appeal documentation
- Completing participant forms with respect to worker-initiated appeals, when appropriate
Notably, WE objects to Board/Commission decisions to protect appeal time limitation periods.
