Claim Consulting

Claim management is an area in which Midwest Employers Casualty Company (MECC) has redefined the way businesses purchase workers’ compensation excess insurance.  We help our self-insured, large deductible and reinsurance clients achieve best practice results in their workers’ compensation programs.  To this end, we collaborate with our business partners, third party administrators (TPA), and employers to facilitate the implementation of innovative and proven claim management strategies to achieve best practices outcomes and to reduce the client’s total cost of risk.

Areas of Collaboration

We partner with our customers and their “claim administration staff” to provide first rate claims expertise in the areas of Medical Management, Settlement and Recovery on our clients most expensive claims.   The “extra pair of eyes” provided by MECC on serious injury and catastrophic injury claims helps our clients save money while ensuring that injured workers receive the highest quality medical care.

Catastrophic Injury, Medical Management

Managing a catastrophic injury claim means managing both medical and indemnity costs.  MECC, in our role as an excess insurer, handle numerous serious and catastrophic injuries on behalf of our clients.  As a result, we have developed skills in managing the costs and directing treatment on catastrophic injury claims.  These skills are available to all clients of MECC.  These skills include:

• Management of catastrophic injury claims
• Identification/assignment of expert catastrophic nurse case managers.
• Nurse Case Management consultation on catastrophic claims: brain injury, spinal cord   injury, burns, and amputations
• Home modification resources.
• Medical cost projection assistance for reserving purposes.
• Medicare Set-Aside expert resources.
• Discounted pricing from catastrophic injury “centers of excellence”.
• Deep discounts on durable medical equipment.
• Pharmacy Benefit Management Coordination

Claim Administration Support

Claims administration is one of the most important functions in any workers compensation program.  At MECC, we work with both TPAs and Self Administered claim staffs to promote claim “best practice” results.  We educate claim administration staff on: proper excess reporting, the art of reserving, ABCs of self insurance, understanding the excess insurance policy, “best practice” communication and how to apply MECC online services to a clients program. 

We also consult on any reported claim and act as a resource for any claim questions that may arise.