No matter what side you are on, the question “How much is the case worth?” is the all important one! Accurate reserve setting takes into account multiple factors including: venue, job/earning ability, the specific injury; current and future medical expenses, treatment, diagnosis, prognosis, permanent loss/damage and specific claimant information. The goal of this process is to not to over or under reserve a claim, but to find the truest amount, and do it as quickly as possible.
Many of the factors involved are medically driven. As a LNC/ NCM, I am often asked to help with analyzing medical information/records on a claim to assist with reserve setting. The clearer the medical information, the more accurate the reserve will be. Unfortunately, sometimes the medical details can get lost in the overall process. Here are a few ways a LNC/NCM can assist with initial reserve setting and/or periodic reserve assessment:
- Help determine damages sustained by the injured party.
- Medical record review for analysis and comment of current medical information and proposed treatments.
- If appropriate, communication with the client to obtain information about injuries, medical care, personal specifics, and complaints.
- Onsite medical assessments to gather medical information from the medical providers and client
- Life care plans
- Task assignment for real time analysis of medical information.
- Attorney, client or adjuster education on disease process, condition, healing parameters and/or recovery timeframes.
- Field or telephonic case management
Sometimes getting a clear understanding of the medical aspects of a claim can be challenging. However, with the help of a LNC, NCM, physician and other medical providers, an accurate analysis of the available medical information can be obtained and analyzed.
Remember a small amount of accurate medical information can make a BIG difference in dollar expenditures!