Insurance Claim Audit Services

 

Any insurance carrier that is serious about policyholder service, efficient work flow, employee satisfaction and profitability will focus their attention on improving the claims handling process. Likewise, if an insurance carrier is looking to absorb another carrier’s claims or is conducting due diligence, a claims processing audit should be part of the examination. Utilizing the experience we have gained from servicing multiple carriers and technology-driven best practice metrics, CatManDo offers you a comprehensive claims audit service with a real-world operational edge.   

 

The claims handling process has many moving parts that encompass claim handling guidelines and file quality, field adjusting practices, examining and settlement oversight, all of which must be done with real time accurate reserves. It also includes some subtle considerations such as the organizations claims classification philosophy and even the culture of the carrier. By utilizing our third party perspective and expertise, CatManDo can uncover the nuances of the claims process within your organization that will impact efficiency, work flow and bottom line profitability. Unlike other time and resource intensive audits, our team employs an efficient, fast track deep-dive methodology that provides practical options for immediate implementation. 

 



CatManDo does not employ a one size fits all audit methodology. In fact we strive to customize each audit to fit your identified needs. We analyze specific audit criteria and provide feedback and trend results based on peril, location, representation, frequency, severity, denials, re-inspections, appraisal or litigation. We identify the strengths and weaknesses within each type of claim and show you how current practices impact indemnity, LAE and DCC cost as well as their effect on customer satisfaction and policy retention. Past audits have revealed several areas for improvement that include:

 

  • Lack of adherence to field adjusting guidelines
  • Little to no application of policy, coverage or endorsements
  • Over scoping and pricing of estimates
  • Failure to nail down the “story” and relate it to the physical damage
  • Inadequate reserve practices

 

While just a sampling of what we have found, allowing these issues to continue can create adverse loss ratios that are out of line with industry norms and expose your entire operation to unnecessary costs and even litigation. We invite you to contact Mr. Chuck Ross at CatManDo today to learn more in-depth details about our claims audit service and discuss how it may provide an immediate benefit to your organization.

P.O. Box 89239, Tampa, Florida 33689, Phone: (813) 689-5513, Fax:813-689-5461

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