The Novo SST team works closely with each member company on workplace injury claims management. Our consultants keep the interests of the group front and centre while still treating each member as a separate entity.
Our objectives are to:
- Ensure effective management of claims while maintaining good labour relations for the employers involved;
- Review the eligibility of workplace accident claims under the Act respecting industrial accidents and occupational diseases (AIAOC);
- Promote the employment continuity program (temporary assignments and rehabilitation) with concrete, proactive action;
- Uphold employers’ rights while respecting individuals;
- Implement management initiatives aimed at reducing costs (Bureau d’évaluation médicale assessment request, eligibility review, suspension of indemnity, request for division or transfer of imputed costs, etc.;
- Work with the safety group’s various service providers, such as lawyers and expert physicians.
As well, to ensure optimal service, our claims managers always take a proactive and business-oriented approach, while respecting the safety group’s legal and contractual obligations.
Claims management activities include:
- Collection of relevant data for case management;
- Verifying eligibility and drafting challenges and appeals to the Direction de la révision administrative or the TAT, as appropriate;
- Working with lawyers on case preparation for TAT appeals;
- Return-to-work recommendations (temporary assignments, accommodation and rehabilitation);
- Preparing and drafting medical and ergonomic assessment mandates;
- Designated physician services to obtain medical documents and provide medical analysis of occupational injury cases, as necessary;
- Preparing and drafting requests for the division or transfer of costs imputed by the CNESST when applicable and beneficial for the safety group;
- Annual review of the most costly cases to ensure that every potentially applicable division request was filed with the CNESST within the time limits (quality review);
- Involvement of designated physicians, if necessary, in the analysis and preparation of requests;
- Over-the-phone member support with the CNESST during a worker’s rehabilitation process;
- Ongoing maintenance of an up-to-date list of active cases and related actions taken, for internal management and quality review purposes.
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