- Claims Management
- Claim Review and Reserve Analysis
- Experience Modification Rating Analysis
A designated claims consultant will monitor and work in conjunction with the insurance representative in controlling the cost of your claim. Our goal is to ensure clients are satisfied with the results of their unfortunate loss. Helping you to provide the information needed to successfully achieve the desired outcome, the following services are examples of how this can be accomplished.
Detailed Coverage Analysis
When reservation of rights letters and denial of coverage letters are issued, we perform an in depth analysis of the insurance policy against the letter to determine if proper application is made. If we determine there is a discrepancy to the clients benefit, we will then compose a letter of rebuttal to the insurance carrier asking them to reconsider their coverage position.
Assisting in the Claims Investigation
We interact with you from first notice to final settlement. We maintain active involvement in discussions with our clients and their claims adjuster to insure they are getting the claim service they deserve. Our participation in the claim investigation can help provide accurate and important information that otherwise may have been overlooked causing an entirely different outcome to the claim.
Developing Reporting Guidelines and Special Handling Instructions
We will meet with you and establish written reporting procedures for all lines of insurance purchased. These guidelines will tell you how to report every type of claim and provide the forms necessary to provide J.W. Terrill or your insurance carrier the information needed to facilitate a claims assignment. Special handling instructions are designed to outline specific claim handling services. These instructions are negotiated by both parties as part of the customers insurance program and will include contact information, litigation guidelines, reserve advisory notifications, settlement discussions and closing notices.
Periodically throughout the year your claim consultant will review and provide a written summary of your open claims. A claims review helps an organization ensure their insurance carrier or claim service provider represents your interests as a policy holder. These reviews can be general or focus on specific areas such as reserving, settlement strategy, litigation practices, trends and just plain improper claim handling techniques. The effectiveness of a review, in most cases, presents a positive resolution for all parties. Ultimately this process can help to lower your loss ratio, lower your experience modification rate and have a positive result in controlling your insurance premiums.
J.W. Terrill uses ModMaster® to project and verify our clients experience modification ratings. There are several enlightening reports/graphs that can be developed with the software that makes it very easy to explain the whole process to a client and shows them trends of certain causes of loss. We use this software for many of our clients and especially those in the construction industry as it is very important to identify specific claims which may be putting them in a position to be over 1.00. The specific loss report helps to tell the story behind the numbers.
The workers compensation modification factor can often be an overlooked or misunderstood element of an employer's workers comp policy. While most employers realize that a lower workers comp mod is somehow a good thing, many don't make the connection between this number and their premium costs. Others don't realize that a mod of 1.0 is just average, and they may have considerable opportunities for saving on their workers comp premiums.
This analysis can save you thousands of dollars in workers’ compensation by teaching you:
• How your mod factor is calculated
• How to interpret your company's mod worksheet
• How to ensure that your rating is accurate
• How losses impact the workers compensation premiums you pay
• Ways to control and improve your mod
• Differentiates you from your competition by enabling you to understand and communicate the
mod like never before.