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Alternative Dispute
Resolution Program Working with selected
insurance carriers the NECA / IBEW collective bargaining group provides premium
discounts to contractor employers using the Alternative Dispute Resolution
(ADR) program. This program cuts workers' compensation costs by reducing
litigation and by providing free professional guidance for injured workers. How does the ADR program
work? If a worker covered by the
program suffers a work-related injury or illness and files a claim, the
worker can receive knowledgeable advice from a workers' compensation expert
called an ombudsman. If disputes arise regarding the treatment or benefits,
the ombudsman gives information and advice to the injured worker on what
course of action the worker may wish to take. The ombudsman acts as a liaison
between the worker, the insurance company, and medical providers to resolve
problems in a satisfactory manner as soon as possible. How much does the ombudsman’s service cost? What if the worker is not
satisfied after talking to the ombudsman? Nearly all of the disputed issues
are resolved at the Ombudsman stage of the ADR process (over 97% of the
issues). However, if the worker
is not satisfied, he or she may request mediation. The Ombudsman will provide
the injured worker with notice of his or her mediation rights, which will
include a form for requesting mediation.
The mediator will discuss the problem with the parties and attempt to
achieve an agreed upon resolution.
The mediation is paid for by the employer or the insurer at no cost to
the injured worker. The mediation
will be completed as soon as possible depending on the availability of the
parties. Is there any recourse if mediation fails? Yes. Once the mediator
completes his report the parties are notified of their rights to formal
Arbitration, which is a formal trial of the merits of the case. Attorneys are precluded from direct
participation in the ombudsman or mediation stages, but direct attorney
involvement and participation is afforded at the Arbitration. The request for Arbitration must be
filed within thirty (30) days of the issuance of the mediator’s notice
of completion and result. Neither
the ombudsman nor the mediator participate at the
Arbitration. Less than 3% of the
cases reach the Arbitration stage in the NECA/IBEW ADR program. The costs of the Arbitration are paid
for by the insurer or employer.
Attorney fees are the responsibility of the parties to the
arbitration, respectively. Can the worker predesignate his or
her medical provider? The ADR program uses an
exclusive list of providers that the IBEW has approved. A worker who has
suffered a work-related injury or illness must chose
a medical provider from the IBEW list. Overall, what is the advantage of an ADR program? By providing its own
professional guidance for injured employees, this program helps cut legal
expenses, reduce the red tape in claims resolutions, and promote a speedier
return to work after injuries. How to Place Your Workers' Compensation Coverage in an ADR
Program
NECA
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