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Quality Auditing and Validation
We will audit your files,
including those from specialty areas, to confirm they are being
handled and reserved in accordance with your company guidelines and
applicable state insurance regulations. |
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Claim Settlement Program Analysis
How do your results compare to industry averages? We
will provide you with an analysis of your expense and indemnity
handling and of related controls. In addition we can help you evaluate
five critical areas:
Organization Resource Allocations – Are resources
properly utilized to maximize your productivity?
Claim Triaging – Are the right people or
entities handling your files?
Cycle Time – Do your files reflect timely
contact and resolution?
Customer Service – Can your customers say
they are completely satisfied with your claim service?
Retention – Are you losing market share
because of claim performance?
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Third Party Administrator or Vendor Auditing/Evaluation
If you outsource claim solutions, do you monitor the
results of the Third Party Administrators (TPAs) and vendors you use?
If not, you can outsource these tasks to us. We will review your TPA
and vendor results, and evaluate them as compared to your objectives.
Or, we will perform an independent review and analysis of TPAs and
vendors you are considering employing in the future. |
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Claim Compliance
Reviews Have you ever faced a Market
Conduct Exam? Why wait for exam results, possible monetary penalties
or business practice challenges? Allow us to perform a sample market
conduct review on your files for potential Department of Insurance
concerns. Early detection of possible problems can save you and your
company the embarrassment and expense of an unsatisfactory Market
Conduct Exam. |
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Core Process Analysis
We will review your core processes looking for
improvement areas using Six Sigma or other process improvement tools. |
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Organizational
Process Studies Do you need to review your
organization for ways to improve your bottom line? We can review and
analyze your operation to look for individual opportunities or overall
process flow improvement. |
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Claim Training
Advisement We can review current claim
training program effectiveness and assist in the development of any
enhancements. |
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Defalcation Reviews
You want your employees and vendors to handle claims in
a professional manner. But, do you really know for sure that everyone
is doing the right thing? What safeguards do you have in place? Do you
suspect potential internal fraud? Or, that a vendor may be taking
advantage of you? We can help confirm that claims processing and
payments are proper. |
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Claim Strategy
Design/Execution We, at
Objective Viewpoint, have
extensive experience in mapping out strategies for the short or long
term. We can help confirm, enhance or reformat your current claim
strategy and, if necessary, work with you to re-design your processes
to conform to this vision |
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Litigation
Analysis
We will perform specific claim file handling reviews on
litigation practices for property and injury claims, as well as such
specialty areas as bad faith and diminution of value.
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Special Projects
Do you
have a special project in mind? Do you need assistance with it? If so,
give us a call.
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