Risico Claims Management

Experienced claims professionals for both public and private employers, working to get injured employees healthy, fit, and back to work.

Consistent Professional Service


Risico was founded to provide professional, effective, and consistent claims administration services for employers throughout California. Our professionalism is demonstrated by qualified, knowledgeable and courteous technical staff that understand that the best claims results are achieved with complete and timely claims investigation, which includes prompt communication with the injured worker, employer, and treating physician.

Sensible Reserving Practices


Our claims management standards are also based on the belief that employers are best served when case reserves reflect the expected ultimate cost of the claim based on the most current information available.

Commitment to Careful Stewardship

Risico is committed to professional and consistent stewardship of all claims records. This means that we take care in organizing and maintaining claims files and records. Risico includes timely, complete and meaningful documentation of actions, decisions and judgments in the claims records.

Personalized Client Attention


The most personalized claims handling can also be the most effective. Risico tailors our systems, work processes and expertise in a way that complements your corporate culture. To ensure that your claims run smoothly, our client services department will work with you to build special instructions for your account, so that everyone is familiar with your needs.

Constant Access to your Claims Information


We offer 24-hour on-line access to claims information and a staff of over 50 qualified individuals to help you manage and understand claims processes and data.

Risico Claims Management, Inc. has developed effective claims management processes to ensure that any and all claim exposures are promptly identified.

  • Insurance Coverage
  • Compensability AOE/COE issues
  • Fraud
  • Third Party Subrogation Recovery
  • Litigation Potential
  • Return-to-Work opportunities
  • Medical Control
  • Claims Reserving
  • Development of Apportionment

Our highly trained, experienced staff have backgrounds in almost every type of Workers’ Compensation environment, which include:

  • Large Corporations
  • Small Businesses
  • Employers with Multiple Locations
  • Self-insured Public Entities
  • Self-insured Private Employers
  • Agriculture

Risico can customize its services to suit the claims reporting and handling requirements of any specific client. Our courteous, professional staff is available to help you manage the cost of your Workers’ Compensation claims by providing transitional or modified return-to-work solutions to assist in keeping lost time to a minimum.

Risico strives for excellence in its adherence to well-defined standards of effective claims handling, in tenacious pursuit of two objectives: (1) Responsible and timely administration of benefits in compliance with the law, and (2) Excellence in claims handling, including intelligent claims investigation that identifies questionable claims, and prudent cost containment practices that allow greater medical control and reduction in claims cost.

Risico also utilizes a panel of experienced outside vendors to provide ancillary services that also can contribute to superior claims result. This panel includes:

  • Workers’ Compensation Defense Attorneys
  • Investigators – AOE/COE, surveillance
  • Lien Representatives

Risico also manages medical costs by the use of a Medical Provider Network, furnishing employees with access to appropriate, quality medical providers; while additionally helping to contain medical costs by keeping all medical treatment within the network.

  • Physicians in every medical specialty
  • Hospitals and Clinics
  • Pharmacy Benefit Program
  • Surgical Facilities
  • Durable Medical Equipment providers
  • Interpreters
  • Medical Transportation Vendors

As an extension of these services, Risico Claims Management and Risico Total Managed Care offer early intervention services and Nurse Case Managers to provide telephonic, field on-site  case management, utilization review, a Return-to-Work Coordinator and Medical Bill Review services to guarantee compliance with California’s Official Medical Fee Schedule.