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Self Insured Company...Is this better or worse for my claim?
#1
OK, I'm feeling really incompetent right now. This whole WC thing is getting more complicated by the minute. I've been reading and found that there are two types of companies, those that are self insured and those that buy WC insurance...correct?

So will someone please explain if there is a difference in the laws pertaining to a claim made with a company who is self insured versus one that pays for ins. Is there a difference in how the claims are handled? Do I have the option of choosing my own doctor since they are self insured?

I can't say that I have had too much of a problem getting treatment and approval for any diagnostics needed. Only a slight problem with a NCM that resolved quickly. My company uses SRS to manage claims and SRS uses another company for the NCM. Will it become more difficult to get those approvals as time? Is my employer making the decisions or is it SRS? Feeling like things are about to change. Just not feeling the love from the employer anymore LOL.

After a conversation with my HR manager today, I found out that my company is self insured and of course they made it known that my surgery and med bills will hit the stores bottom line. Upper managements bonuses are based off of store sales budgets and bottom line.I can see they think that I am jeopardizing their bonuses. I can't imagine the cost of a shoulder surgery can destroy a 45 million dollar stores bottom line.

Thanks for any insight. I consider myself relatively intelligent but feeling out of my league with this WC stuff.

WOW do I ever feel the bulls eye on my back now!
 
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#2
technically 3 types. there are those rare employers that can be considered permissibly uninsured.
the laws on acquiring coverage and reporting loss information etc. are different.
self-insured employers have more say so in making some claims handling decisions as the claim and all the costs are theirs and not the carriers.
more information on Nevada comp system
http://dirweb.state.nv.us/WCS/employee.htm
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
(((After a conversation with my HR manager today, I found out that my company is self insured and of course they made it known that my surgery and med bills will hit the stores bottom line. Upper managements bonuses are based off of store sales budgets and bottom line.I can see they think that I am jeopardizing their bonuses. I can't imagine the cost of a shoulder surgery can destroy a 45 million dollar stores bottom line))).

This is when your told these things, to ask yourself some questions;

1. Would the other emplyee's then pay for you and your injury if you stop treatment? (NO)

2. Would the employer then give you lots of extra money to stop treatment? (NO)

3. Would any other employee injured really care about your bonus if they were injured? (NO)

This is just simple talk, to get other employee's and you upset. Why they do it, I have no clue. But have heard this many times in the past. Putting employee's against other employee's, so when they do come back to work, life will be rough on them, and they quit their job. A strong person simply works right through it all, and everything always goes back to normal in time.
Reply's are intended solely for informational purposes. They are based on personal opinions, experience, or research and are "not to be taken as fact or legal advice", otherwise, always consult an attorney or a doctor.
 
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#4
My employer was self insured.....I had a nice settlement...my attorney told me it would have been more if they weren't self-insured....the only difference I saw.
 
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#5
Bad Boy Bad Boy Wrote:This is just simple talk, to get other employee's and you upset. Why they do it, I have no clue. But have heard this many times in the past. Putting employee's against other employee's, so when they do come back to work, life will be rough on them, and they quit their job. A strong person simply works right through it all, and everything always goes back to normal in time.
Generally this happens because the managers bonus will be affected. It is often not the $$$ on the bottom line that impact the bonuses, although it certainly could, rather many companies will reduce or eliminate a managers bonus if they have a lost time claim, or one that is major medical.

I am not saying the behavior NVWorker describes is acceptable, only that this is most likely the reason they experienced it.

NVWorker, where did you get my picture from? Smile
 
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#6
Thanks everyone! Reading through the statutes now 1171. So much info, my brain is on overload. It's nice to have this forum though :-) I think I may have gotten lucky with my doctor though, he is supposedly the best shoulder guy in town. Let's hope so! He seems very optimistic about me being back to work a couple weeks after surgery. Concerns me a bit since it took me 3 weeks after just a gallbladder surgery and this seems much more extensive.

Quote:1. Would the other emplyee's then pay for you and your injury if you stop treatment? (NO)

2. Would the employer then give you lots of extra money to stop treatment? (NO)

3. Would any other employee injured really care about your bonus if they were injured? (NO)

So true Bad Boy, thanks.

Thanks again everyone...oh, ACE25, I'm so glad you like the picture I found of you :-) handsome little thing LOL
 
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