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  1. 6 Essential Elements To Explore When Choosing A Third Party Administrator April 27, 2010

    Posted in Due Diligence, SPOT on Ops.

    A Third Party Administrator (TPA) is often the best way to handle claims for an organization. Many self-insured and captives choose to outsource their claims instead of creating their own internal operation. Whether to get expertise in a particular areas, or not wanting to invest in the infrastructure to build a claims department, using a TPA can be a smart business decision. So what make a good TPA and what should you look for? In order to find out you must conduct a comprehensive due diligence of the TPA you are about to hire. This is especially the case when that TPA will be holding and managing your claim dollars. Besides understanding the financial strength and capabilities of the TPA, it is also important to know whether they will be able to meet your data needs, provide consistent claims handling, and work to lower costs where they can.

    In this weeks post I address 6 essential elements, and questions, that should be explored as part of any due diligence when selecting a TPA

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  2. 4 Key Areas For Claims Handlers To Review When Dealing With Follow Form Policies April 15, 2010

    Posted in Coverage.

    A follow form excess or umbrella policies is a type of policy were the terms and conditions of an underlying layer of coverage are adopted and incorporated into the “following” layer. While these policies may still have independent provisions and exclusions, they will nonetheless relate back to the underlying, “followed” policy, for most of the terms. In many situations this way of handling excess coverage prevents inconsistencies and ensures there are no gaps in coverage. However, in complex matters involving multiple layers of coverage, or when the language conflicts with the underlying layer, many problems can occur. In claims involving these types of policies, claims handlers must fully analyze all the terms and conditions of all the policy provisions to truly understand the coverage applicable. This weeks post give 4 key areas for claims handlers to consider when dealing with follow form policies.

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  3. New Claims Technologies To Help Companies Drive Revenue And Differentiate Themselves April 12, 2010

    Posted in Claims Technology.

    New Study By The Gartner Group Shows 10 Technologies With The Greatest Impact For The Property/ Casualty Industry To Drive Revenue. In this post I comment on 4 solutions that can have a dramatic impact on claims and improve bottom lines. Failing to adopt new technology will put companies at a competitive disadvantage. Every company should look to evaluate their current systems and offerings and create a strategic plan to keep up-to-date with software and solutions. Staying ahead of the curve is a sure way to help drive costs down and stand out from those who don’t.

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  4. Cutting Costs Without Overloading The Claims Handler – Part 2 Of The Series April 6, 2010

    Posted in SPOT on Costs.

    In part 2 of this series on cutting cost without overloading claim handlers I given an example of hiring a part-time employee to review legal bills. As noted, sometimes specific types of work, such as legal bill review, subrogation and anti-fraud, can best be handled by dedicated resources. Hiring a part-time employee that can focus on an area of claims is sometimes the best way to get results. Overworking claims handlers with additional tasks not part of their core job function – to evaluate and settle claims – can result in some aspect of their job suffering. Key cost cutting initiatives, such as Anti-Fraud and subrogation recovery, get put aside by the handler and never get the fullest attention needed to be successful. Take a look at the latest example of solutions that work.

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