Dealing with MSP Can Feel Like Walking Into a Maze The Medicare Secondary Payer Enhancement Act of 2010 (HR 4796) is a new piece of bi-partisan legislation introduced on March 9, 2010. It is designed to streamline Medicare Secondary Payer reporting and provide some finality for insurers required to reimburse Medicare for “conditional payments” of…
Why are Attorney Evaluation Reports sometimes so light? I was recently conducting an audit of claim files and had the opportunity to review a significant number of Attorney Evaluation reports from a variety of law firms. Like many other things in life, some were better than others. What seemed to be most glaringly consistent was the inability of counsel to truly provide an assessment of exposure and what the case is worth. Every counsel evaluation report should contain 5 basic components that I outline and attorneys should be required to provide their actual valuable opinion. [More…]
The Benefits Of Forming A Captive Are Great – IF – You Set It Up And Manage It Correctly The use of captives as an alternative means for managing risk is growing rapidly (read a nice overview of captives at the Captive Counsel Law Group). Changes in laws, increasing tax benefits and control over assets…
It may seem counter intuitive, but with the right technique a heartfelt apology can help lower claims costs and exposures There is a wave of civility sweeping through the world of risk management as a way to lower exposure and reduce costs: Apologize. Maybe mom was right when she stood there and said “now say you’re sorry.” In fact, there are some very impressive statistics in the area of medical malpractice around the simple use of an apology. Regardless, there is a proper way to apologize while protecting rights and some policy considerations to consider.
Claims departments employ professionals that want to do a good job for policy holders as well as the company, and claims guidelines should help foster those goals. Before drafting guidelines there are a few things that should be considered and we, along with our fellow blogger Phil Loree, suggest 7 things a company should consider when drafting claims guidelines.
Managing litigation is an easy way to save extra expense costs on claims files. A strong litigation management program designed to help foster improved communication, and streamline defense of insureds, benefits all parties involved. As I wrote about the cost savings benefits of out-of-the-box claims handling, using new and forward thinking strategies for litigation management is an excellent way to save money. Using specialized vendors, claim handlers can further control legal costs as well as enhance their defense.
Today’s modern claims systems have a wealth of knowledge about every aspect of claims operations. With the right reports it should be easy to get a basic snapshot of how effective your claims are being managed, and how well your business is doing. With all that information where is one to start? What are the key metrics that should be reviewed by claims and business executives to better understand their operations? We give three specific report types that claims executives should review on a regular basis to get a valuable snapshot of their organization.
The Centers for Medicare/Medicaid Services (CMS) have announced the following: CMS advises all NGHP RREs that the date for first production NGHP Input Files is changed from April 1, 2010 to January 1, 2011, effective immediately. Read the complete announcement at the CMS website in “What’s New.” This is clearly a welcome change and one…
Recently I was discussing bad faith and notice procedures with attorney Phil Loree Jr., an expert on reinsurance and arbitration issues and author of the the Loree Reinsurance and Arbitration Forum blog. I thought this was a timely conversation as it reinforced the concepts regarding procedures and the potential risks when they are not in…
Insurance Market Conduct examinations are a regular part of the insurance business. Besides the stress of the exam itself, being cited for violations can result in costly fines. Regardless, many citations can be avoided. Every year, insurance compliance solutions provider Walters Kluwer releases its annual study of top ten reasons insurance companies are found to…