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Tag Archives: Claim Auditing

  1. A Claims Tale Of Three Little Managers And Their Review Programs June 20, 2012

    Posted in Best Practices, Claims Auditing, Compliance, SPOT on Issues.

    We have all head the story of the 3 little pigs but have you heard of the 3 claims managers? The Manager of Straw, the Manager of Sticks and the Manager of Bricks are all motivated to do the right thing but they go about it in very different ways. One had no program in place to review their operation, one had a basic process in place and one used a detailed program to review claims. Read on this story and see how problems occur and are managed differently.

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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. The Need For Claim Auditing In Catastrophe Loss Situations Such As The Gulf Tragedy June 15, 2010

    Posted in Best Practices, Claims Auditing, Rick Woollams (Chartis Chief Claims Officer), SPOT on Issues.

    The tragedy of the Deepwater Horizon and the aftermath seem to be a topic of constant conversation. From an insurance perspective there is a large amount of criticism being brought to bear on the claims process. The massive administrative organization that has been established to handle what are already tens of thousands of claims is an undertaking that could be fraught with problems. In today’s post from The Claims SPOT we discuss how auditing in the Catastrophe situation is an important part of the process to ensure claims are paid quickly and appropriately while at the same time preventing fraud.

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