Claims Management

Ability Management® in Action

Our Claims Management focuses on abilities and empowers people to take responsibility for their recovery.

For each employee who reports a claim, a dedicated claim team plays a big role in that empowerment effort. How? By taking a positive approach to claims management, and creating an effective working relationship that encourages recovery and return-to-work.

Assessment and treatment planning

• Telephonic reporting of claims gets claim management started immediately.
• Our electronic and clinical guidelines apply the right resources to process and manage claims effectively.
• Our assessment of a claim looks beyond the medical diagnosis and focuses on what the employee can do.
• Clinical case management teams recommend individualized return-to-work treatment plans using expertise drawn from appropriate resources:
  • physicians and nurses
  • vocational rehabilitation counselors
  • physical therapists
  • occupational therapists
• When we need additional medical review, we have access to independent networks of physicians to help ensure fair and objective claim decisions.

More resources

• Behavioral Health Case Management — handles mental illness claims. Here sensitive claim decisions are made by people who understand psychiatric issues —advanced practice psychiatric nurses, psychiatric rehab staff and licensed social workers — all of whom have access to a dedicated group of psychiatrists and psychologists.