Rancho Mesa's Alyssa Burley and, Vice President of the Construction Group, Sam Clayton talk about Alternative Dispute Resolution and how it can help limit workers’ compensation litigation.

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Director/Producer/Host: Alyssa Burley

Guest: Sam Clayton

Editor: Lauren Stumpf

Music: "Home" by JHS Pedals, “News Room News” by Spence

© Copyright 2021. Rancho Mesa Insurance Services, Inc. All rights reserved.

Transcript

[Introduction Music]

Alyssa Burley: Hi, this is Alyssa Burley with Rancho Mesa's Media Communications and Client Services Department. Thank you for listening to today's top Rancho Mesa news brought to you by our Safety and Risk Management Network, StudioOne™. Welcome back, everyone.

Welcome back everyone. My guest today is Sam Clayton, Vice President of the Construction Group with Rancho Mesa. Today, we’re going to talk about alternative dispute resolution and how it can help limit workers’ compensation litigation. Sam, welcome to the show.

Sam Clayton: Good morning Alyssa, it’s nice to be back in StudioOne™.

AB: Now, we know workers’ compensation rates have fallen steadily over the last ten years, but businesses in California still pay the highest rates in the country. And, California has the highest frequency of permanent disability clams, the highest medical cost per claim and the highest litigation rates per claim. How does alternative dispute resolution or ADR help to mitigate the issue?

SC: Well, to mitigate the friction within the workers’ comp system, California and several other state legislatures in the early 90s developed legislation that would permit unions and management to jointly develop an ADR program or “carve-out” agreement that resolves disputes outside the state workers’ compensation system with benefits that are at least equal to the benefits required by the Labor Code.

AB: Will you explain how ADR is different from traditional workers’ compensation insurance?

SC: Sure, ADR is an alternative to the traditional approach to workers’ compensation claims.  With ADR, an injured worker will report the injury and then use the services of a neutral ombudsmen hired by the union trust who is knowledgeable in workers’ compensation law to quickly determine if the injury is work related. The ombudsmen will recommend to the injured worker the appropriate treatment and other benefits owed within the carve-out agreement.

AB: What are the benefits of using an ADR for the employer?

SC: Union ADR provides employers with flexibility to manage the overall cost for their workers’ compensation program by promoting voluntary agreement early on with the injured worker on effective medical treatment to reduce litigation over the scope of medical treatment. ADR can also provide an accelerated claims resolution, faster medical treatment and potentially quicker return to work for the injured employee. 

This process limits litigation with the services of an ombudsman and, if needed, mediation and arbitration procedures designed to resolve the claim quickly and appropriately. Since this is a very specialized arena, workers’ compensation carriers typically have a separate claims division that are well versed in the nuances of ADR claims.
AB: Sam, if clients have questions about an ADR or their workers’ compensation insurance, what's the best way to get in touch with you?

SC: I can be reached at (619) 937-0167 or sclayton@ranchomesa.com.

AB: Sam, thank you for joining me in StudioOne™.

SC: Thanks Alyssa.

[Closing Music]

AB: This is Alyssa Burley with Rancho Mesa. Thanks for tuning in to our latest episode produced by StudioOne™. For more information, visit us at ranchomesa.com and subscribe to our weekly newsletter.