Pinnacle group
Claims Concierge
Root Cause Analysis
Root Cause Analysis
These services are focused on reducing litigated claims.
- Weekly contact with injured worker to check on their wellbeing and obtain answers to their questions.
- Injured worker can call or text
- Obtain medical reports on date of appointment
- Prepare letter offering modified duties
- Coordinate return to work
- Track and log all claims
- Create claims dashboard to track by location, District Manager, General Manager, and other criteria.
- Provide updated reserves (when provided access or provided with loss runs)
- Point of contact for broker, carrier, and medical providers.
- Notes of claimant conversations provided to adjuster
- Attend claims review
- Maintain contact with injured worker and all parties until claim is closed.
Root Cause Analysis
Root Cause Analysis
Root Cause Analysis
Root Cause Analysis investigations post incidents help your business reduce frequency and severity. We identify the cause of the incident which allows your safety or maintenance department to take the appropriate action.
Onsite investigation
Review video footage
Interview relevant parties
Identify cause of incident
Provide list of recommended corrective actions to avoid reoccurrence.
If equipment was involved we will investigate if there was any defect, malfunction or alteration.
If you have our Concierge services we will add our recommended actions to prevent reoccurrence into your claims dashboard. This will allow your safety and maintenance department to enter date corrective action was taken, who completed it, and what was done.
Workers' Compensation Investigations (AOE/COE)
Workers' Compensation Investigations (AOE/COE)
Workers' Compensation Investigations (AOE/COE)
Let us conduct a comprehensive investigation into your workers compensation claims. We get you the facts and preserve evidence.
Did the injury Arise Out Of and in the Course Of Employment (AOE/COE)? Our reports address AOE/COE, identify possible affirmative defenses as well as providing a list of Red Flags.
We interview the alleged injury worker, witnesses/co-workers, supervisor, and any other relevant party.
Review of personnel file and any video.
Obtain claimants history regarding: employment, medical facilities, chronic health issues, prescribed medications, accidents, hobbies/habits, financial, legal, and criminal.
Social media and claims history searches.
When needed we obtain CHP and Coroner's report.
We cover more than 50 topics in our reports.
Our services are provided onsite, telephonically or via video conference.
No charge for RUSH assignments.
Surveillance
Workers' Compensation Investigations (AOE/COE)
Workers' Compensation Investigations (AOE/COE)
Let our surveillance team verify if your injured workers level of activity is consistent with their treating doctor's medical report.
Does their level of activity go beyond their work restrictions and subjective complaints?
Are they working a second job?
Are they golfing despite claims of a low back injury with the inability to stand or walk for more than 10 minutes?
We provide a comprehensive report that can assist an employer or their carrier to determine the claimants true level of activity during their workers' compensation claim