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The Claims Management Reality
CASE HISTORY #4
CLIENT: CONSTRUCTION COMPANY
CLAIM: ABDOMINAL PAIN
Employee files a Worker’s Compensation claim for abdominal pain experienced while driving a truck from one of the job sites to another. Claimant went to a clinic and received medical treatment and submitted bills through the worker’s compensation carrier.
As part of our claims management program, we review copies of bills and accident reports. After discussions with the insured, we determined that this was not a work related injury. This was a non-compensable worker’s comp claim and should have been submitted only as a health claim.
On our recommendation, the client informed the carrier that this claim was submitted in error.