Oftentimes, an insurance adjuster may suspect that the potential exists for a workers compensation claim to be subrogated, but would like a second opinion from an expert before launching a full-blown investigation; alternately, the adjuster may hold the opinion that the subrogation potential is not great, but would like a second opinion for confirmation of his view.
Obviously, the better the documentation presented, the more likely that cases with good potential can be further pursued, and weaker cases can be quickly dropped with minimal expenditure of expense and time.
The following are simple tips for providing your expert with a sound basis for case evaluation before an onsite inspection takes place.
1. A good description of the incident is very helpful; rather than stating “the worker was trapped in the machine”, if would be better to state specifically where in the machine the worker was trapped, preferably showing the specific location with photographs with arrows and captions, as necessary. If the worker was injured by accessing a hazard after removing or opening a guard, provide a photo of the guard.
2. If possible, provide the information from the manufacturer’s data plate of equipment involved in the injury in writing or by photos. If the age of the equipment is available, that may be an important factor in a subrogation matter, as well as model numbers and technical specifications.
3. A description of what the worker was doing at the time of the incident is valuable data. For example, he may have been involved in regular production, equipment maintenance, tool changes/ equipment setup, clearing a jam, cleaning the machine, etc. Was the machine running at the time of the incident? Any available witness statements should be provided.
4. It may be desirable to contact the employer for short interviews; for example, “Is there a written lockout/ tag out program in place?” The name and telephone number of a supervisor knowledgeable about the incident would therefore be helpful to provide.
We recognize that you may not have all the suggested information, so just provide what you do have and we will do our best to track down additional helpful information. A review of these tips may help you to remember to provide this kind of data on future claims.
Roger Davis, a senior consulting engineer at The Warren Group, is a licensed professional engineer in South Carolina, North Carolina, Alabama, Georgia and Mississippi. He holds a Bachelor of Science in Mechanical Engineering and a Master of Business Administration from the University of South Carolina. He’s also achieved a Certificate in Crane Safety from the Georgia Institute of Technology, Distance Learning and Professional Education Center, Atlanta, Georgia. Roger is a certified fire and explosion investigator and certified vehicle fire investigator. He is experienced with municipal water, sanitary sewer, and storm water system design, construction, and operations. His expertise also includes property damage and personal injury investigations involving municipal utilities. He is an accomplished gas and diesel engine mechanic and has more than 30 years of experience with hydraulic plumbing and piping issues. Roger has investigated claims and injuries ranging from pressure piping system failures and material and personnel handling equipment to large engine failures and fires involving machinery, generators and vehicles.