Claims Services

Claims - Casualty

• Consulting on the claims reporting processes.
• Monitoring adjustment and settlement process; filing proof of loss.
• Claims advocacy on behalf of clients in disputed coverage or claim handling issues to avoid unnecessary coverage litigation.
• Evaluate the effectiveness of your claim management program through the use of audits, claim reviews, operational assessments, benchmarking, and developing performance goals.
• Analysis: The use of data tools, such as loss triangles, stratified total incurred reports, and other ratio reports help transform data into meaningful information.
• Assessment of claims administration: A claim operational assessment is a review of the entire claim operation that includes a claim audit of open and closed claim files. The review will focus on administration, structure, compliance, controls, and claim work flow.
• Mass Tort claims management from policy archeological services to e-discovery, to claims advocacy.
• Assistance in selecting cost effective and superior legal representatives
• Reduce collateral requirements
• Accelerated claims closure
• Utilization of structured settlements
• Loss portfolio transfers

Workers Compensation Claims Management

• Third Party Administrator review
• Managed Care
• PPO development and review
• Utilization Review
• Return to Work program development and review
• Claim file reviews and audits
• Takeover claims administration
• Reserve analysis
• Protocol review
• Medical bill reprising
• Occupational Therapy review and auditing
• Medicare compliance audits. Provide rated ages for Medicare Set Asides

Complex Property Claims

• Quantification and recovery of business interruption, property and financially complex insurance claims.

Forensics- Fraud & Dishonesty

• Occupational fraud investigation and recovery of employee, vendor or supplier dishonesty claims