News & Blog

Montana – Costly Results

Montana is well known as a difficult jurisdiction for property, casualty and workers’ compensation claims.  Not only is the Supreme Court one of the most liberal (pro plaintiff) in the nation, they aren’t afraid to make ‘new law’ at times.  The duty to defend is a high duty in Montana law and has not changed […]

RMIS Risk Manager of the Year – Bill Zachry

Congratulations to the RMIS Risk Manager of the Year Honoree, Bill Zachry!  We have known and worked parallel to Bill since the late 1980’s.  He has always been a kind, thoughtful professional in an otherwise challenging business…workers’ compensation claims.  Mr. Zachry was among a few in California during the very difficult days of the 80’s […]

Use of Medical Case Managers (Nurses) and Fees

Midland Claims Service, Inc. and Industrial Injury Claims® has for over a decade approached the use of nurses on workers’ compensation claims as a common sense tool in the adjuster’s tool box.  Unfortunately, the practice of retaining and working with medical case managers on less than catastrophic injury claims seems to be somewhat contrary to […]

More Money Flows Into the WC TPA World – Sedgwick is Sold

According to Joe Paduda, KKR has acquired a majority state in Sedgwick for over $2 Billion.  His column indicates that the current management doubled the company’s value in a fairly short period of time.  We are confident that Paduda’s prediction of pressure upon Sedgwick management to increase top line and bottom line revenues will bear […]

Can we learn from the experience in Illinois? WCRI study released.

Similar experience in Illinois as we have seen in Montana, adjust the per visit / per encounter / per procedure reimbursement rates downward, and the utilization rate and number of procedures for similar claims seems to rise.  Illinois has enjoyed a significant medical cost decrease in their WC system due to their reforms, while Montana […]

What is Claims Man? …or claims professional in today’s lingo…

What is a claims person (today’s language for a claims man)? According to Edward G Robinson in the movie Double Indemnity the claims professional has many aspects to what they do every day. Amazing how so little and yet so much has changed since the 1940’s…

Study Shows Surgery Rate in CA Higher than WA…Financial Motivation?

Joe Paduda’s recent column discusses a recent study showing the significantly higher rates of back surgery (fusion) in CA than in WA, where the threshold is far higher than in CA before significant surgery can be approved under workers’ compensation.  We agree with the tone of the article, where there is financial motivation to do […]

Customer Feedback!

The claims industry can be challenging.  Needs and demands of stakeholders throughout the process can be so monumental that in certain circumstances the actual reason to have an adjuster, that being to lead and facilitate a claim from date of injury to resolution, can become cloudy.  From injured worker and their family to the employer […]

Sedgwick – Another National TPA On The Block

Sedgwick is for sale.  The following is from Business Insurance: (Reuters) — Private equity-owned Sedgwick Claims Management Services Inc., one of the largest U.S. providers of claims services, is exploring a sale that could value it at more than $2 billion, according to four people familiar with the matter. Sedgwick, which was acquired by Stone […]