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Category Archives: Due Diligence

  1. 4 Keys to Managing a Successful Outsourced Claims Operation October 30, 2013

    Posted in Best Practices, Compliance, Due Diligence, SPOT on Issues.

    All things being equal there are many fine TPAs in the market that will provide wonderful service to your insureds in a cost effective and comprehensive manner. Initially you think you have chosen a good one. However, as time goes on you realize you are not exactly getting what you expected from your TPA. So what happened?

    It matters little what your reasons for outsourcing were. Bottom line is if you didn’t take certain steps to properly select and manage a TPA you are likely to end up with problems. The partnership you form with your TPA will be fruitful if you take key steps to select and manage them in a way designed to foster long term success.

    Learn how in our latest post!

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  2. Claim Reviews Empower Better Decisions By Putting Critical Information In Hand March 30, 2011

    Posted in Best Practices, Claims Auditing, Compliance, Due Diligence, SPOT on Ops.

    Insurance is as much about having the right information at the right time as anything. Whether it’s an underwriting choice to price a risk correctly or a claim decision as to when to a play a claim, having the best data available can make or break an organization. Despite this fact, many organizations fail to take advantage of tools and rights available to them prior to making critical business decisions. Claim reviews are empowering tools to help make better decisions. Staying ahead of the competition and managing risk is a key component of any any successful organization. The claims review allow decision makers to have the most available data to make better decisions. In this weeks post we discuss 8 reason when they should be done and speak to going beyond the claim files to fully understand the substance behind the numbers.

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  3. Quick SPOT: 6 Security Tips To Keep Portable Technology Safe For Claims August 27, 2010

    Posted in Claims Technology, Due Diligence, SPOT on Ops.

    If you are like me you keep everything on your laptop and cell phone. Numbers, corporate information, claims data, and even some of the dreaded non-private personal information of others. Claims data is filled with information that if lost or stolen could be detrimental to both the company and the individual. Many companies today issue corporate cell phones and blackberry devices as well as laptop computes in place of desktops. It’s a modern world and we are all expected to be connected. Partial work at home arrangements also mean this information is traveling from location to location which can increase the risk that things may be lost or stolen.

    Take a look at these suggestions to help keep your claim information safe and secure in the latest post from the Claims SPOT.

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  4. 5 Questions To Ask Property Adjusters Before Making That Partnership July 9, 2010

    Posted in Due Diligence, SPOT on Ops.

    Selecting the right partner for your property adjustment needs can be absolutely crucial to meeting stake-holder needs across the claims process. Making the wrong decision up-front can create countless problems down the road.

    At a high level, claims executives might look for synergy, good philosophical fit, and a proven track record. But what about day-to-day operational considerations? What should be included in your detailed market evaluations, your informational meetings with potential vendors, or even your RFI and RFP for property adjustment services?

    Learn how to not not shortchange the process by not asking the right questions in Taylor Smith’s posting of 5 questions to ask property adjusters before making the partnership.

  5. The Importance Of The Pre Bind Claims Review In The Reinsurance Context June 29, 2010

    Posted in Claims Auditing, Due Diligence, SPOT on Ops.

    Reinsurance companies faced with a new submission often review loss runs and other financial data to determine the effectiveness of an account. However, numbers only tell half the story and in order to get a complete picture of a cedent’s submission, it is important to have an understanding of the claims department. What is the company’s reserve philosophy? What kind of systems do they have in place? How are claims staff measured? Conducting a comprehensive pre-bind review is an important step to help minimize the risk.

    In this post, the Claims SPOT explores the importance of the Pre-Bind review in the Reinsurance context.

  6. 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