The experts provided tips for adjusters working claims that could benefit from the use of a structure.
Seek out a specialist. “As soon as you realize you’re dealing with somebody who’s Medicare eligible or will be soon, that’s when you really need to contact a specialist that deals with Medicare compliance,” said Buechner.
Start the process early. “The earlier you can start the process, the better off you’re going to be down the road when you’re actually trying to achieve settlements. You need to find out if conditional payments have been made by Medicare. Those need to be reimbursed and taken into consideration when you’re developing a settlement strategy. It’s true of anything in life, the more prepared you are before you get involved with something the better off it’s going to turn out,” Buechner said.
Consider the dollar amount of the potential settlement. “Most MSAs, probably, that are under $10,000, or maybe under $25,000, those will probably be paid in cash. Anything greater than that, it sure does make sense to try and structure those. Because then, whatever money you save you can put toward the other areas of the settlement,” said Buechner.
Listen. “When I talk to the adjusters, and when we always talk about settlement in training and things like that, the biggest aspect, I think, for any adjuster is just to listen to their injured worker. Find out what it is that’s going to benefit them in regards to their path to wellness. If it’s a lump sum, or if it’s a structure with a Medicare set aside, find out, really, what it is from a benefit standpoint that’s going to be beneficial for the injured worker that’s going to give them the opportunity to get back to work or to make sure that their medical is covered for the life of their claim,” said Kuss.
The experts agree that structured settlements are integral to resolving workers’ compensation claims involving permanent disability.
“It [structured settlement] protects Medicare’s interests, but it protects the claimant, protects the insurance carrier, and it protects the attorneys that are involved as well,” Polinsky said.
Read the main article: Workers’ Comp Structured Settlements Beneficial in Medicare Set Asides
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