Tag: FROI

ESF, Catastrophe, and After-Hours Reporting in FNOL

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June 1st, 2021

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catastrophic fnolHandling events that are challenging to anticipate lives at the heart of first notice of loss. Our philosophy is that any and all customer requirements take absolute precedence. In this vein, a variety of services are pertinent when it comes to covering FNOL and Absence Management needs. Through our proprietary intake solution, we have fewer constraints than a software/ASP vendor, and can implement customizations quickly.

In addition to the various essential first notice services, we cover electronic state filing as well as call center support for catastrophic events and after-hours developments. Our custom solutions leverage a variety of features including:

  • Customer set-up profiles provide flexibility in customizing workflows, including personalized greetings, lines of business, custom questions and report types, policy, carrier and claim office assignments, distributions, etc.
  • FROI and state specific questions maintenance system
  • Catastrophic escalation identification and tracking
  • Robust distribution module
    •

    To learn more about what services best suit your organization and discuss implementation strategies, contact us.

    Understanding FROI and SROI

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    January 13th, 2015

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    Understanding what an FROI (First Response of Injury) and SROI (Subsequent Response of Injury) report is can have a huge impact on when, and how, your company handles Workers Compensation claims. Here’s a quick breakdown to help differentiate the two.

    FROI – A report prepared by the employer, or other parties, that describes the events and injuries. It is also known by other names, such as the Employer’s Report of Work-Related Accident/Occupational Disease.

    SROI – A report required twice a year while a claim is open; when benefits start, stop, or change; when a lump-sum payment is made or when a claim closes.

    Electronic state filings for these reports can be a big headache in Workers Compensation Claim administration. Requirements vary by state, and missing or invalid data leads to time consuming resubmission, filing delays, excess staff time, and fines.

    Click here to learn about solutions that will help with the review and submissions for each type of report.

    Outsourced EDI Filing

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    July 25th, 2014

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    Mandatory EDI (electronic data interchange) filing may be the biggest of all headaches in Workers Compensation Claim administration. Requirements vary from state to state. Missing or invalid data leads to time consuming resubmission, filing delays, excess staff time, and even fines.

    Our Electronic State Filing Program carefully reviews all submissions for both FROI and SROI as well as annual filing requirements. We follow up for any missing or incomplete information making sure submissions received are accepted. Though these tasks can be accomplished in-house, for most organizations it is more efficient and effective to outsource it to experts in the field.

    The state of California recently released statistics to all companies filing Workers Compensation (FROI). Actec had a success rate of 99.1% of all reports submitted that were accepted by the state on the first submission. The industry average for the one-year period was 77.4% acceptance on first submission. Actec works diligently to make sure your reports are filed timely and accurately, thus avoiding re-filing and potential fines. To learn more about how an ESF program can improve operations at your organization,     contact us.

    First Notice of Loss Key Terminology

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    July 11th, 2014

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    There several important terms when discussing first notice of loss. Though many are unfamiliar with the concept, it stands as a crucial component of many successfully operated large businesses.

    1. FNOL – Abbreviation for First Notice of Loss, the initial report of a claim or incident resulting in loss of an insured product. A crucial element of insurance coverage.
    2. FROI – Abbreviation for First Report of Injury, the initial report of a claim or incident resulting in injury to an employee. A employer practice required by law.
    3. Claim Management – The conveyance of an insurance-related claim through a system of communication and investigation to ascertain the appropriate compensation. The more adept and timely the claim management, the less shrink for insurers and the higher satisfaction for clients.
    4. Incident Reporting – A system of documentation for FNOL in which specific details must be thoroughly recorded to ensure proper claim management. Well-trained personnel and a modern, sophisticated incident reporting medium significantly reduce costs due to slow resolution, shrink, and other organizational issues.
    5. Claim Intake Specialist – Personnel cross-trained in claim management and incident reporting to deliver maximized resolution for client and insurer with minimized investment of time and resources.

    Numerous other components comprise a comprehensive FNOL program, but familiarity with the basic terms makes it much easier to understand the process of first notice of loss and the benefits of leveraging FNOL in large businesses.

    Popular Incident Reporting & Absence Management Blogs

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    May 20th, 2014

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    Incident reporting, absence management, and the claim intake associated with these processes can prove challenging for most larger businesses. Are claims falling through the cracks? Could these lead to unnecessary legal action against your company? Is your organization losing valuable time as a result of a lacking absence management program? To learn how these solutions can improve your bottom line, check out these popular blogs:

    First Report of Injury and the Importance of Timely Response

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    April 9th, 2014

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    FROI, or first report of injury, is a critical component to compliance with workers comp guidelines. Whether or not an employer agrees with an employee, the FROI must be filed. Typically reports are required when an injury causes an employee to miss 5 or more paid workdays, and must be submitted within seven business days of the fifth missed day of work. Each state has its own FROI form, available online, which should be completed in quadruplicate. One copy must go to the state, one must go to the employee, one to the insurer, and it is recommended to keep one for business records.

    If a doctor sees the employee, and the employee complains of work-related injury, he or she is also compelled to file a report. Neither report exists to comment on the veracity of the employee or employer, solely to begin a paper trail to ensure that dates, times, and places can be known to as great a specificity as possible when ascertaining the proper course of action. Like FNOL (first notice of loss), the more promptly and accurately FROI forms are completed, the more likely a positive outcome.

    7 Key Terms in the Field of First Notice of Loss

    Posted on

    March 2nd, 2011

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    There several important terms when discussing first notice – they may seem esoteric, but their meaning and execution have enhance many businesses and improved the quality of many lives. A positive FNOL interaction is key to successful business operation, but also makes the difference between brightening someone’s day and besmirching it.

    1. First Notice of Loss – The initial report of a claim or incident resulting in loss of an insured product. A crucial element of insurance coverage.
    2. FNOL – Abbreviation for First Notice of Loss
    3. First Report of Injury – The initial report of a claim or incident resulting in injury to an employee. A employer practice required by law.
    4. FROI – Abbreviation for First Report of Injury
    5. Claim Management – The conveyance of an insurance-related claim through a system of communication and investigation to ascertain the appropriate compensation. The more adept and timely the claim management, the less shrink for insurers and the higher satisfaction for clients.
    6. Incident Reporting – A system of documentation for FNOL in which specific details must be thoroughly recorded to ensure proper claim management. Well-trained personnel and a modern, sophisticated incident reporting medium significantly reduce costs due to slow resolution, shrink, and other organizational issues.
    7. Claim Intake Specialist – Personnel cross-trained in claim management and incident reporting to deliver maximized resolution for client and insurer with minimized investment of time and resources.

    There are other component of FNOL , but familiarity with these 7 key terms will illuminate much of our industry and its purpose.