North American Risk Services, Inc. Workers’ Compensation BEST PRACTICES DOCUMENTATION: • All notes to the file should strive to be objective, clear, concise, factual, and relevant to the claim. • The documentation and reporting allow the file to “speak for itself,” in a manner that tells the story of how the claim has progressed and is moving forward. • File documentation is accomplished primarily via Claim Notes and appropriate utilization of Note Types as well as posting pertinent correspondence, reports, and other materials to the claim including but not limited to medical reports, medical bills, and nurse case management documentation. • File reporting is an ongoing process and is consistently and timely updated as new information develops. • Reports are utilized in compliance with company guidelines and include but are not limited to Large Loss, Reinsurance, Pre-Trial and Trial. STATUS REPORT: • A Status Report includes an identification of the critical/unresolved issues regarding Coverage, Compensability, and Exposure, and the investigative tasks to be completed to resolve each critical/unresolved issue that leads the Workers’ Compensation Specialist to develop an evaluation of Coverage, Compensability, and Exposure; and move the claim to disposition, resolution, and/or negotiation. • The Workers’ Compensation Specialist’s Status Report is a clear, concise, and pro-active approach to bringing the claim to a fair and timely resolution. • The Status Report is dynamic, reflecting the strategies for fairly resolving the critical/unresolved issues as additional information is developed and analyzed. EXPENSE MANAGEMENT: • The North American Risk Services, Inc. – Workers’ Compensation Center of Excellence team strives to avoid even the slightest appearance of impropriety when facing actual or potential cases of conflicts of interest by maintaining “arm’s length” relationships with vendors, independent adjusting firms, attorneys, and others with whom it does business. • Workers Compensation Specialists are responsible for exercising reasonable business judgment in the selection, retention, and management of external resources to facilitate fair and prompt resolution of claims. • Scopes of assignments to external resources should be specific and limited to assure appropriate expenditures, and sufficient to provide good faith investigation, analysis, and resolution of claims. NARS’ Best Practices were created by and for the internal use of NARS and are confidential, proprietary and trade secret documents protected by the Uniform Trade Secrets Act and applicable state/federal law. They may not be copied, distributed, or reproduced, in whole or in part, without NARS’ express prior written authorization. Unauthorized use or distribution may be subject to civil and/or criminal penalties.