Risk Management
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Claims
SELF believes in providing expert claims management to every member. In order to deliver on this belief, SELF has contracted with our third party administrator, The Sedgwick Group. With almost 60 years of expertise, Sedgewick will continue to deliver unbiased, superior claims management for the SELF membership. Several unique claim practices stands out and contribute to the high quality of service that has been delivered to SELF over the years. Key practices include:
- SELF Dedicated Adjusting Team –All SELF workers compensation claims are handled by a dedicated team of adjusters who work exclusively on SELF. This means SELF specific claims handling instructions can be developed and followed.
- Web Based Claim Reporting –in order to simplify and expedite the claims reporting process, SELF uses a frictionless online reporting system, developed exclusively for Sedgewick clients.
- Three Point Contact –within 24 hours of the workers compensation claim being reported, a SELF adjuster is assigned and the investigation process starts with a “Three Point Contact” process. The adjuster communicates with the injured District employee, the District where the incident occurred and the medical team working with the injured employee. Adjuster involvement will continues until the claim is closed to assist our members every step along the way.
- Accident Investigation –SELF has developed an in-depth accident investigation process ranging from speaking with and recording the injured employees statements surrounding the incident, speaking with supervisors and other witnesses to the injury, and reviewing photographs and other documents relating to the incident. This comprehensive investigation helps to improve the level of care that can be delivered when a compensable claim is involved.
- Workers Compensation Benefits –not every claim filed under the SELF workers compensation program is compensable. The adjuster’s job is to evaluate the factssurrounding the incident/injury and communicate whether this claim will be covered by workers compensation or another form of medical care. Disputed and denied claims are communicated to the concerned parties.
- Open Claim Reviews –the SELF “Claim Committee” meets monthly to review several open claims within the program. The district(s) involved in these claims are invited and encouraged to participate as we focus on open communication and program transparency.
SELF firmly stands behind the belief that we are a member-driven and member-owned workers compensation pool. We heavily value transparency, member communication and encourage our members to be engaged in the processes.
Loss Control
Loss Control is a risk management technique that seeks to reduce the possibility of a loss occurring and/or reduce the severity of those that do occur.Partnering with SELF to prevent workplace injuries not only prevents loss and unnecessary expense, but preserves the pledge you make to your employees to provide them with a safe workplace. The safety and loss control programs offered by SELF are designed with these factors in mind.
Since SELF started, Gallagher Bassett Services, Inc. and their Risk Control Consulting Services (RCCS) group have helped members develop and maintain successful safety and risk control programs. Our mission is to provide you with timely delivery of quality consulting services, which results in a tailored program that aggressively manages workers compensation, related loss costs, and improves operational efficiency.
- Safety Training –SELF provides on-site safety training that can be customized to your Districts' unique safety requirements.
- Hazard Identification –SELF performs a hazard identification study that will give Districts a firsthand look at those areas contributing to potential losses. These areas are often controllable as we help to make the schools a safer place.
- SELF Safety Grant –Based on SELF's loss history and analytics, we found that over 45% of all work related losses come from slips, trips and falls.With the goa c9f l of minimizing these claims, SELF Safety Grant Program is created to provide our members with risk-conscious district equipment that contribute to the reducing slip/trip/fall injuries.
- Educational Seminars –SELF hosts risk control seminars with invited speakers from legal, claims and pool administration.
- SELF offers unique risk control services that has helped control and lower hazards commonly found in School Districts.
Besides those listed out, SELF offers several other Risk Control and Safety programs to help safeguard our members.