Many larger companies carry certain risks themselves, either through a Captive Insurance Company or simply through a fronted self-insured program. However, with this type of program the claim process needs to be managed with the highest level of service.

Depending on the type of program, claims handling can be farmed out to a Third Party Administrator on a bulk basis, or adjusters can be appointed on a case-by-case basis. These companies’ ability to handle the field work is important to the claim process.

However, in our experience programs that are left to be handled solely by a Third Party Administrator (TPA)  or  adjusters cannot be maintained at the necessary quality level. In our view it is important that resources are committed to the oversight of these programs to ensure claims servicing quality is maintained. Unfortunately this work is often retained in-house and  can end up way down the list of work priorities, not getting the attention it requires.

EIC Can:

• Prepare in-house claims reporting procedures
• Oversee TPA and adjuster work
• Liaise between the TPA/Adjuster and the company’s risk and senior management personnel
• Supply periodic claims bordereaux and analysis
• Provide coverage advice
• Manage claim negotiations and settlement support services
• Audit case files
• Provide periodic TPA contract reviews