Claims are one of the single largest contributors to a company’s total cost of risk.  Whether this cost is derived from actual claim payments or premiums paid out to an insurance company by means of a fully insured guaranteed cost program, the negative outcome remains the same if proper oversight is not in place.  If claims are not being managed as efficiently as possible, there is a trickle-down effect which ultimately results in higher premiums and collateral requirements for the organization.

Unfortunately, insurance companies and third party administrators all too often become complacent while handling their customers’ claims.  This occurs for a variety of reasons, such as over-extended adjusters, lack of accountability, and internal organizational realignments, to name a few.

Corporate Risk Consulting, Inc. offers numerous services which can be specifically tailored to assist any organization with its claims management needs.  When working with Corporate Risk Consulting, Inc., you receive assurance that industry best practices are being implemented.

Our ultimate goal is to help you reduce your total cost of risk.  Below are some of the claims management services that Corporate Risk Consulting, Inc. consultants offer pertaining to your workers’ compensation, general liability, property, and auto liability programs:

   •  Claim Program Review – Conduct a comprehensive review of your insurer’s or third party administrator’s policies and procedures for the management of claims.  We can offer recommendations for improving efficiency as it relates to the current claim management design and/or special handling instructions.

   •  RFP Management – Manage the third party administrator selection process.  We will create requests for proposals, create comparison charts, interview qualified candidates, and provide selection recommendations.

   •  Claim File Review – Determine if incidents and accidents are being properly investigated, if root cause analysis is being completed to identify areas of opportunity as relating to loss control, and if  all files are being documented as required.

   •  Claim Fee and Cost Analysis – A review of all claims to determine appropriate avenues to assist in the reduction of claim-related costs, expenses, and provider fees.  Recommend strategies for expediting the settlement of claims when in the client’s best interest.

   •  Reserve Analysis – Complete historical and open claim reserve review to determine the accuracy and execution of all reserving practices. Recommend and implement new reserving guidelines accordingly.

   •  Claims Management Outsourcing – Process and manage all claims, inclusive of reporting to insurer or third party administrator, perform root cause analysis, attend hearings and mediations as required, negotiate claim reserve amounts with insurers, provide reports to client, settle and/or advise on the settlement and closure of claims with client as mutually determined.

   •  Claim Reporting Management – Monitor timely reporting of claims to the insurer to ensure appropriate coverage under the policy and adherence to policy conditions.

   •  In-House Training – Afford training to clients’ in-house personnel as relating to claims management, risk management information systems, claims documents, and accident investigation.

   •  Stakeholder Alignment – Align all involved parties to assure that all lines of communication are open.  Involved parties include the client, insurer, third party administrator, attorneys, and medical provider networks when applicable.