Claims Management

Our members are incented with surplus to keep costs down.

Our Board of Trustees requires the MADSIF, Michigan-based claims team to support that effort.

It is critical, within the first 24 hours of an injury, to steer it in the right direction. Our claims adjuster immediately seeks input from:

  1. The employer
  2. The injured worker
  3. The physician

Ryan Roscia The adjuster collaborates with the member, ensuring that all details are considered (length of employment, age, medical limitations, performance, employee’s motivation to return to work etc). Then a determination of compensability or denial is made. If compensable, the adjuster works CLOSELY with the member on a plan to return the injured employee back to work, with better treatment. The team will verify throughout the claim that:

  • Employee is keeping all appointments
  • Medications are appropriate
  • Employee has return to work options
  • Employee is motivated to return to work

MADSIF also has a nurse case manager that works with the adjuster and the treating physician. The nurse’s expertise in occupational injury creates collaboration with the treating physicians and referrals to specialists to keep the claim moving.

The claims process of a self-insured fund has been proven to save at least 20% on claims costs. This is due to the aggressive processes as directed by the Board of Trustees and the incentive to return surplus.

It is different here at MADSIF.