As professionals in a Maryland-based company, our claims adjusters are proficient in handling claims for Maryland employers. We are intimately familiar with the workers' compensation community and the laws that govern this jurisdiction. This proficiency is invaluable to employees and injured workers when injuries occur.
Our claims services include aggressive claims management. This process focuses on timely claims handling and quality medical care with a return-to-work objective for all injured workers. Our comprehensive claims management services include the following[Expand all] [Collapse all]
Prompt injury reporting is the single, leading factor in controlling the cost and duration of a claim. Chesapeake Employers makes injury reporting easy -- 24 hours a day/7 days a week.
Submit the Employer's First Report of Injury (FROI) on-line (eServices account required);
Call our Injury Reporting Hotline at 1-888-410-1400; or
Fax the report to (410) 494-2002.
The Chesapeake Employers' Claims Adjuster and Nurse Case Manager work closely together to ensure quality medical care and appropriate return to work for all injured workers. This team approach helps to facilitate necessary communication between the employer, injured worker, medical provider, and attorneys, if applicable.
Timely and accurate compensability decisions are essential elements of effective claims handling. After an injury is reported, the claim will be referred to the claims department for assessment. The adjuster will determine if a claim is compensable, administer benefits, if warranted, and monitor activity on the file. A nurse is always available to assist the adjuster with medical questions, especially in complex cases.
In addition, the integrated team approach allows for timely involvement from Safety Services as well as from our Legal Department and Special Investigations Unit. Together, all of these resources work to obtain successful outcomes for the injured worker and his or her employer.
This network of participating pharmacies in Maryland allows prescriptions to be filled with no out-of-pocket cost to the injured worker. An Express Scripts prescription number is provided immediately upon confirmation of a newly reported claim. Note: The issuance of an Express Scripts number is not a determination of compensability.
This component of our claims process allows pre-authorization of medical services to ensure quality care to injured workers as well as improved communication among providers, employers, and the injured worker. Pre-authorization of medical services also ensures prompt payment of medical bills.
The Independent Medical Examination (IME) is a very useful tool in the claims handling process. The IME is a medical evaluation performed by an independent physician/specialist at the request of the employer/insurer. The IME is effectively used by the claims adjuster to evaluate the medical status or return-to-work status of the injured worker.
When an injured employee is unable to return to his or her pre-injury job due to a permanent disability, he or she may be eligible for vocational rehabilitation services. Our team of claims professionals work with vocational specialists to achieve the goal of returning injured workers to suitable gainful employment in the workforce.
Maryland Workers' Compensation laws are "no fault" in nature. However, Maryland employers/insurers have a statutory right to recover money spent on claims caused by a negligent third party. We have established a dedicated Subrogation Department to investigate each claim with subrogation potential. When third-party liability is identified, our Subrogation Department will aggressively pursue negligent third parties to recover money that has been paid on behalf of claimants by Chesapeake Employers. Recoveries by the Subrogation Department can be cash returns or credits against future claims payments. The Subrogation Department has been responsible for recovering millions of dollars for our clients.