The Cost of a Claim: Recognizing Risks Before They Escalate
Fernando Branco, MD, FAAPM&R
AVP, Claims & Chief Medical Officer, Midwest Employers Casualty
In this episode, Dr. Fernando Branco explains how small workplace injuries can become costly claims when they aren't handled early and carefully. He shares the biggest warning signs, including late reporting, delayed medical care, poor coordination between providers, misdiagnosis, and the influence of psychosocial factors or pre-existing conditions. Dr. Branco also discusses why some claims escalate from simple injuries into long-term, expensive cases, especially when treatment is delayed or the wrong path is taken early on.
He also outlines practical ways to manage these claims more effectively, including early intervention, strong care coordination, nurse case management, bill negotiation and planning for settlement. He emphasizes that medical inflation, attendant care and unnecessary treatment can quickly drive up costs, making it essential to act quickly and understand the claimant’s full situation. Overall, the episode offers a clear reminder that the earlier a claim is addressed, the better the outcome for everyone involved.
*The views and opinions expressed in the Public Risk Management Association (PRIMA) blogs/podcasts are those of each respective author/speaker. The views and opinions do not necessarily reflect the official policy or position of PRIMA.*
Fernando Branco, MD, FAAPM&R
AVP, Claims & Chief Medical Officer, Midwest Employers Casualty
Responsibilities
Fernando has presented in several conferences, podcasts, webinars and blogs in the insurance industry, mainly with regards to worker's compensation. He supervises the medical team at Midewest Employers and provides medical supervision for the claims department.
Fernando also provides consultant services to several other Berkley companies as a physician.
Business Experience
Fernando has 30 years of clinical experience as an MD, board-certified in physical medicine and rehabilitation, pain medicine and addiction medicine.
Insurance work for the last 7 years Worker's Compensation.
Education
- MD Universidade Federal do Rio Grande do Sul UFRGS
- Residency PM&R - ABBR Rio de Janeiro Brazil
- Masters in PM&R - Rio de Janeiro Brazil
- Residency PM&R - University of Kentucky
- PhD Exercise Physiology - ABD - University of Minnesota
- Board certification in PM&R, Pain Medicine and Addiction Medicine.
