Level: Intermediate
Why you need this course:
After completing this course, you’ll be able to analyze a workers compensation claim as well as a workers compensation subrogation claim.
Upon successful completion of this course, you should be able to:
- List the four types of notice of injury in the workers compensation system and the requirements for each.
- Explain how to determine coverage for a workers compensation claim.
- Given a case, explain how workers compensation reserves are set.
- Describe the factors that affect workers compensation reserves and the pitfalls adjusters should avoid in setting reserves.
- Given a case, explain how to conduct an investigation of a workers compensation claim.
- Describe the procedures and issues involved in paying and managing workers compensation claims.
- Explain why and how state second injury funds operate.
- Describe the issues relating to procedures insurers follow in terminating workers compensation benefits.
- Describe the procedures for denying a workers compensation claim.
- Explain how a disputed workers compensation claim can be settled.
- Describe the ramifications if an unlicensed adjuster is found to be handling claims in a state that requires licensing.
- Explain how and why penalties may be assessed for mishandling claims.
- Describe a workers compensation adjuster’s role in loss control and workplace safety.
- Describe the incentives an employer or an insurer has for pursuing workers compensation subrogation.
- Given a case, determine whether subrogation is economically viable.
- In support of this objective, you should be able to:
- Investigate the accident for third-party liability
- Identify potentially liable third parties
- Determine negligence
- Apportion liability
- Determine negligence tests and subrogation restrictions
- Determine amount of potential recovery
- Conduct a cost/benefit analysis
- Describe the subrogation process
- Describe potential subrogation scenarios for claims involving:
- Vehicles
- Products
- Premises
- Explain how the insurer can become a party to a claim against a third party.
- Describe the questions to be answered in determining how to best resolve a lien.
- Describe the circumstances in which a lien is resolved without stipulation and with stipulation.
Cost: $20 per Professional Development Hour (PDH). Information on Professional Development Hours (PDH) provided can be found here.
Workers Compensation Claim Administration and Subrogation Topics Include:
- Types of notice of injury
- Determining coverage for a claim
- Setting workers compensation reserves
- Factors that affect reserves
- Investigating a claim
- Procedures and issues involved in paying and managing claims
- Why and how state second injury funds operate
- Issues relating to procedures insurers follow in terminating benefits
- Denying a claim
- Settling a disputed claim
- Ramifications of an unlicensed adjuster’s handling claims in a state that requires licensing
- How and why penalties may be assessed for mishandling claims
- Adjuster’s role in loss control and workplace safety
- Incentives for pursuing workers compensation subrogation
- Determining whether subrogation is economically viable
- Subrogation process
- Potential subrogation scenarios for claims involving vehicles, products, and premises
- How the insurer can become a party to a claim against a third party
- How to best resolve a lien
Additional Course Resource
Additional Knowledge Solutions
E-mail: customerservice@TheInstitutes.org
Phone: (800) 644-2101
Fax: (610) 640-9576
Mail: AICPCU/IIA
720 Providence Road
Suite 100
Malvern, PA 19355-3433
Customer Service hours are Monday through Friday, 8:00 a.m. to 6:00 p.m. eastern time.
