Pinnacle group
Reporting
Incident Investigations
Claims Concierge
Once an incident or injury occurs call or office and we will:
Complete Incident Report
- We will complete our customized incident report or your internal report for the following incidents: Near Miss, Self-Care, First Aid, Medical Only, Indemnity (lost time), or Fatality.
- Take statements from: Injured Employee, Supervisor, Witness or Co-Worker.
- Email completed report to employers point of contact.
Complete State Forms
- For CA the DWC-1 and 5020 when medical treatment is sought or lost time occurs.
- Submit forms to carrier or Third Party Administrator and to the employers point of contact.
Safety Dashboard
- Create a Safety Dashboard for all reported incidents.
- Dashboard allows employer to sort incidents by: location, manager, reserves, departments, nature of injury, type of injury, and other topics relevant to each employer.
- Submit dashboard weekly to employer.
Claims Concierge
Incident Investigations
Claims Concierge
These services are focused on reducing litigated claims, lowering reserves, returning the injured worker back to work as soon as possible, reducing overall claims cost, and closing claims.
Claims Concierge
- Contact employee on date of injury
- Point of contact for employee
- Weekly calls to employee to see how they are doing and answer any questions they may have
- Resolve employee concerns or issues
- Employee may call or text concierge 7 days a week
- Keep employee informed
- Contact employee on date of medical appointment
- Obtain return to work status
- Coordinate return to work with employer and employee
- Obtain work restrictions
- Draft offer of modified work
- Submit documents and paperwork on employers behalf
- Obtain medical reports
- Point of contact for broker, carrier, and medical providers.
- Provide employer with weekly updates
- Notes of claimant conversations provided to adjuster
- Our claims manager will attend your claims review
- Maintain contact with injured worker and all parties until claim is closed.
Incident Investigations
Incident Investigations
AOE/COE (workers' compensation)
Employers assign incident investigations to our bilingual English/Spanish team members.
We interview the alleged injury worker, witnesses/co-workers, supervisor, and any other relevant party.
We also obtain the claimants history regarding: employment, medical facilities, chronic health issues, prescribed medications, accidents, hobbies/habits, financial, legal, and criminal.
Investigations are conducted telephonically or via video conference.
AOE/COE (workers' compensation)
AOE/COE (workers' compensation)
AOE/COE (workers' compensation)
Arising Out of and in the Course of Employment (AOE/COE). Any workers compensation claim must meet the AOE/COE criteria for the claim to be accepted.
We have decades of experience conducting AOE/COE investigations.
Our comprehensive reports identify possible affirmative defenses as well as providing a list of Red Flags.
Over 50 topics are covered in our reports.
Included is a social media check as well as a check of any previously filed workers compensation claims.
We include a subrogation investigation anytime we identify a third party or that defective or altered equipment was involved.
When appropriate we obtain CHP and coroner reports.
Our services are provided onsite, telephonically, or via video conference.
All fatality claims are conducted onsite.
Surveillance
AOE/COE (workers' compensation)
Surveillance
We conduct surveillance to provide our clients with evidence they can use to determine if the injured workers life's activities are consistent with the subjective pain complaints mentioned to their treating doctor.
Red Flags for surveillance:
Does the injured worker not answer calls during normal work hours?
Has the injured worker also stopped working their second job?
Subjective complaints in a medical report are not consistent with objective findings.
Injured worker refuses to return to modified duties.
Injured worker is off work for a longer period of time than normal for same injury.
These are just a few Red Flags that could trigger a request for surveillance.
Contact us to discuss your need for surveillance.