This post has a lot to with injured workers at really big companies. I’m talking places like United Airlines, Yellow Freight, The City of Chicago, ComEd, etc. But it offers great strategy for those at smaller companies too.
Big companies are often self insured. That means they don’t pay insurance premiums for workers’ compensation in Illinois, but instead are approved by the Illinois Workers’ Compensation Commission to pay all of their claims directly. To do this they have to be financially secure. Some companies go from self insured to out of business (in recent years it’s mostly been coal and steel companies), but even then there is a fund to pay their claims. Here is the most recent list of all self insured companies in Illinois http://www.iwcc.il.gov/SelfInsuredFirms.pdf. It’s an interesting list because there are a ton of companies on there that I’ve never heard of which is amazing because they are all hugely successful.
For some of these companies, they will hire workers’ compensation adjusters to handle the claims internally (Ford Motor does this for example). Most of them, however, use what is called a third party administrator or TPA. So if you were hurt while working for United Airlines, you’ll end up dealing with an insurance adjuster for Gallagher Bassett. The City of Chicago uses Sedgwick.
If you work at a non self insured company, the name of their insurance on your accident date is important and can go in to your strategy. For example, if we know that ESIS is handling your accident, but now your employer is insured by Travelers, it’s possible that ESIS just wants to close out all of their claims with your company and might not worry about how that will affect the company long term. You can use that to your advantage or at least a smart lawyer can.
For bigger companies that use a TPA, they might switch insurance companies, but it doesn’t impact your case the way it does when they aren’t a TPA. In fact you have to be prepared that the new TPA might be looking to make a big splash right away by showing how they think the old TPA was doing everything wrong. This could mean your file gets “reviewed” and all of the sudden your benefits are denied or you now deal with a not friendly adjuster or they send you to an IME with a hired gun.
It happens the same way whenever a defense lawyer gets fired and a new firm comes on. The new firm wants to make a big impression because the better they do, the more business they will get. Who gets hurt by this new found aggressiveness? You do.
These aren’t the worst problems to have, it’s just something you need to be prepared for and ready to counter. Many of the lawyers in our network take the strategy that when there is a new TPA on the case, the best thing we can do is make an early phone call and get off to a good start as well as make sure that your benefits aren’t interfered with.
Big picture, don’t freak out if there is a new TPA or new insurance company on a case. Just know that it’s a piece of the puzzle when it comes to getting you the best result possible.
