Claims Management

Our workers’ compensation claims team practices cost containment, with an emphasis on early intervention, and a proactive approach to return-to-work programs. Our adjusters are highly skilled at providing medical care coordination to minimize the disability period and recovery period without jeopardizing medical stability. We provide empathy and ensure proper medical treatment and other restorative services are timely provided in a logical sequence, while simultaneously controlling medical costs.

Our liability claims team thoroughly investigates and aggressively gathers all facts to determine the scope of loss to lead the claim toward a fair and reasonable closure. Our adjusters confirm the causal relationship of any claimed injuries or damages to the accident in question. We ensure that vehicle appraisal inspections are completed in a timely manner and repair estimates submitted promptly. If coverage disputes arise, our adjusters consult with the self-insured client and a specific strategic plan is agreed upon within the guidelines set by the Fair Claim Handling Act.

Our Best Practice Guidelines meet and exceed industry standards and can be customized to the individual needs of the self-insured. At all times we administer and adjudicate claims in accordance with Florida statutes, applicable case law, and always in consultation with the self-insured.

Presumption, PTSD and Cancer Claims Management Expertise

Managing claims for municipalities requires a unique and specialized set of skills. Our adjusters and supervisors are specifically trained in the investigation and management of municipal claims including claims that are unique to police officers, firefighters, and paramedics. Our adjusters have vast knowledge in handling first responders’ claims which include Heart and Lung cases, PTSD, and administration of firefighter cancer benefits. Claims handling protocols for investigation and management are customized with each municipal client. Our data driven claims system produces robust analytics and reports that allow our public entity clients to track, trend, and monitor these distinctive claims.

Reporting

We produce a multitude of electronic standard reports. The reports are developed in different formats including Excel and PDF. The collection of numerous data fields, allows us to provide detailed reports. We will design customized reports for the needs of the client. We also have the capability to provide interactive reports.

Technology

Our Information Technology Department uses an in-house development team to support a completely custom claims administration software program, as well as a web application for our clients. Using our custom-built web application, our clients are able to securely access their live claims data remotely. Both applications access the same data; therefore, when the adjuster enters a note, adjusts a reserve or scans a document, it is immediately available to our client in the web application. Both systems provide integrated scanned documents for review by the adjuster and the client. In addition to providing Electronic Data Interchange with clients, we also provide this service with vendors and the State of Florida.

Loss Control and Prevention

We will provide a loss control professional to work with your safety staff to establish or strengthen your loss prevention efforts. Loss control plays an integral role in lowering the frequency and severity of claims. Our focus is not only on identifying potential workplace issues, but also in developing overall safety programs for employees.

Case Management Team

Our telephonic case management team works in conjunction with the employer and claims adjuster to manage workers’ compensation claims. An accomplished registered nurse, with over 30 years of experience, heads our team. Our case management team also includes a certified disability manager. The case management team takes an active approach and uses their experience to focus on recovery and return to work, while reducing the overall claim cost. They listen to the needs of the injured worker, schedule appointments with qualified medical providers, coordinate care proactively and communicate effectively with all parties involved, producing better claim outcomes.

"Our organization has been associated with Commercial Risk Management since 2004, and we have established a great partnership with them. And it’s more than just handling workers’ compensation claims. They are really concerned about our success as an organization, stepping up even when our needs are other than claims handling, such as offering input into loss costs trends, safety and loss costs savings strategies, litigation management, audit support, continuing education, etc. Their customer service is second to none, usually resolving our issues on the same day, or proactively following up to keeping us informed on outstanding items. You couldn’t ask for a better bunch of industry professionals than those at Commercial Risk Management.”

- Mark C.Resler, CPCU, AIC

Risk Manager

"...Commercial Risk not only provides the services promised, but the staff go above and beyond to provide the best service in the industry. The adjusters are conscientious, experienced, and caring. I highly recommend them as I believe them to be the best third party administrator for workers’ compensation programs….”

- Marisa Martinez

Manager, Employee Health & Workers’ Compensation

"CRM has been instrumental in partnering with our organization to acquire excellent results. My experience as a NP/Case manager and now as the Director of Occupational Health have been outstanding. CRM tailors services to the needs of your organization. I would highly recommend CRM as a third-party administrator."

- Karyn Wagner

Director of Occupational Health

"...Commercial Risk Management has continually proven to be a valuable member of our risk management team. They are genuinely concerned with the struggles we face, and go above and beyond to resolve issues in a timely manner with the utmost professionalism. I would highly recommend them as a third-party administrator for workers' compensation..."

- Mitch St. Jean, CWCL

Workers' Compensation & General Claims Manager

"Having Commercial Risk Management administer our liability and workers’ compensation claims has been one of the best decisions I’ve made for our agency. Every team member from the Adjusters up to the CEO has been so professional and responsive to all our needs."

- Jason Wright

Risk Manager

"I’ve worked with TPA’s, carriers and self-administrated entities for over 30 years. CRM is a highly valued partner that allows us to provide the best possible outcomes to our injured workers, their families and our organization in workers’ compensation matters. We’ve recently had CRM assist with general liability matters and as usual, their team has provided exemplary service. CRM tailors their service to our needs and their model is the antithesis of the one size fits all service approach that is far too common in the industry. I greatly value the team and their advice, expertise and evolving technology platform."

- Alex Davis

Risk Manager

"I’ve had the pleasure of working with CRM since 2009, as they administered claims for the Diocese of St. Petersburg, and for the City of Clearwater. Their experienced and knowledgeable management team, and claims staff have always been able to control and manage our workers compensation claims experience so as to benefit our employees and our financial goals for this program. Their creative claims handling and solutions to these cases makes CRM stand heads and shoulders above others in their field. They are also caring, personable and professional in the manner they approach your business operations and goals. It’s a partnership that works for us in many ways."

- Rick Osorio   

Risk Manager