SeaBright's long history of focusing exclusively on workers' compensation insurance has resulted in a carefully conceived, well-tested set of claims services, each designed to improve results for policyholders. Services include:
Claims Management: To ensure prompt, personal, and focused attention, each policyholder is assigned a lead claims examiner. Case managers work in teams with claims examiners and a national network of health care providers to coordinate all aspects of a claim.
BrightCure PDQ®: SeaBright pioneered the practice of giving physicians direct, ongoing oversight of the care received by injured workers. Through our BrightCure PDQ program, we now assign a physician to any claim that could potentially involve six weeks or more of lost work time, as determined by predictive modeling. SeaBright Physicians have full authority to oversee the claim during its entire lifecycle, including the medical treatment received by injured workers. The program also makes physicians available, as needed, for oversight of less complex claims, and assigns pharmacists or physicians to review all prescriptions for narcotics.
USL&H Center of Excellence: U.S. Longshore & Harbor (USL&H) Workers' Compensation and Jones Act/Maritime Employers' Liability claims are handled in a central location, making it possible for claims examiners to tap one another's knowledge and experience.
Easy Access, Online Claims Systems: To encourage policyholders to report accidents the minute they occur, our BrightNotice telephone and web-based Claim Reporting system is available around the clock. In addition, larger customers can track the status of claims in two ways: through our web-based BrightView Loss Information System or our PC-based Compass system, which records each step of a claim's progress, complete with our claim examiner's notes and comments.
Pharmacy Benefit Program: To lower prescription costs and avoid out-of-pocket expenses, injured workers can obtain injury-related medications at discounted prices from a nationwide network of over 64,000 pharmacies. Affiliate pharmacies also review prescriptions prior to their being filled, and cross-check patient information to help identify any potential adverse effects. In addition, health care providers receive SeaBright's experience-based formulary of effective drugs for various worker-related injuries, with an emphasis on lower-cost generic equivalents, as appropriate. Beyond this, staff pharmacists provide an added level of expertise by reviewing requests for narcotics, guiding treating physicians in weaning recovering workers off chronic narcotics use, and serving as an ongoing resource for our claims examiners.
Our ReadyReturn program helps employers adopt effective strategies for transitioning recovering workers to temporary, alternative employment to promote full recovery, re-capture productivity, and ultimately lower the claim cost. When alternative work is unavailable, temporary assignments are usually available through our national network of charities.
Fraud Detection: Our claims examiners are trained to detect indicators of fraud. If they spot a red flag, they refer the suspicious activity to an independent investigator to pursue the case.
Subrogation Services: Our in-house subrogation unit and liability attorney are expert at identifying recovery opportunities where third-party liability exists.