Case Study #1
Major Carrier Switches to Specialty Claims Management
Client and Program:
A major insurance carrier with a large, specialty general liability program
The carrier saw the need for improvement with their existing third-party administrator (TPA) and began to explore alternatives. After an extensive review, they decided to move their 900+ open general liability claim program to Specialty Claims Management.
SCM Approach: Collaboration and Communication
SCM worked closely with the client to develop a detailed transition plan from the previous TPA to SCM. The objective was to increase the quality of claims handling and to create accountability at all levels. We identified the need for specific technical ability and recommended a seasoned group of adjusters to the client. As we completed the staffing, we simultaneously created specific claim handling guidelines for the program.
All claims were transitioned to SCM, including a complete migration of data and claims history to our proprietary claims administration system. After an initial review, we were able to identify claims that could be immediately closed, while properly reserving for the remaining open claims. SCM has continued to work very closely with the client, communicating regularly with their claimants, attorneys, and all involved parties. Our detailed reporting and litigation planning practices have enabled the client to monitor and manage reserves on even the most complex claims.
Results: Lower Costs, Improved Claims Administration
The collaborative process between SCM and the client has resulted in better information exchange, realistic loss reserve management, and efficient claims handling.
Highly qualified technical staff assigned to account
Detailed reporting and litigation planning
Proper reserve management
Case Study #2
Flexibility and Technology Enable Paperless Claims Handling
Client and Program:
An insurance carrier with a proprietary paperless claims system
A new client approached us with a requirement to adapt our processes and procedures to their electronic claims handling system. SCM’s own online system provided a tremendous amount of flexibility, but a major integration would be required for the two systems to work together seamlessly.
SCM’s Approach: Flexibility and Smart Use of Technology
Initially, SCM and the client developed a detailed workflow based on the client’s existing procedures and system. We then identified common claims practices across both systems and mapped the areas where SCM’s technology could assist in the claims process. Before involving our technology staff, SCM’s management and adjusters identified areas for process improvements, as well as potential pitfalls.
SCM’s team worked closely with our client to develop a solution that could integrate the two systems most effectively. Additional hardware and software was installed at each desktop, and each adjuster was trained on the new processes. In several cases, our adjusters made suggestions that resulted in improvements to our client’s existing process.
Results: Seamless Technology Implementation
The close cooperation between SCM’s technology team, its adjusters, and the client was critical to the smooth transition to the new process and technology and resulted in numerous improvements.
Integrated team process
Adaptation of new technology to best practices
Claims handling efficiency improvements
Case Study #3
Non-Standard Auto Program Makes Quick Transition
Client and Program:
A prominent carrier with a regional non-standard personal auto program
A program administrator was seeking a TPA to quickly take over a mid-sized non-standard auto program that was going into runoff. The carrier’s experience with SCM’s handling of a similar non-standard auto program resulted in SCM’s being hired to take over the program.
SCM’s Approach: Speed and Expertise
SCM immediately assigned one of its top managers to review the program and identify files that could be handled by one of our existing offices. At the same time, we established a satellite office in the local area of the former program administrator, who was shutting down their operation.
We worked with the program administrator and the carrier, and in the course of one week transitioned all files to SCM staff, completed training in the claims handling software, moved all phone and correspondence, and had a fully operational facility up and running. Additional support was provided by SCM’s headquarters staff, providing efficient draft processing, reporting and accounting services.
The program’s execution was monitored by senior management during the transition and throughout the claims-handling process.
Results: Quick and Efficient Program Transition
SCM provided a simple, quick, and effective transition, using its resources in multiple offices, to provide a seamless solution to the carrier.
Upper management expertise and involvement
Multi-office assistance and team approach
Case Study #4
Contract Revision Helps Sub-Contractor Stem Losses
Client and Program:
A large commercial sub-contractor with claims arising under New York State Labor Law
A large New York based commercial sub-contractor was subject to an usually large number of loss notices arising from their primary sub-contractors’ employees, and was seeking to reduce their exposure.
The program administrator and retail agent were perplexed and sought the advice and guidance of Specialty Claims Management. SCM’s senior claims supervisor on the account was well versed in this line of business and was a Labor Law coverage expert. After review of the circumstances, SCM proposed that the insured sub-contractor incorporate a standard work contract (thus triggering a broad definition of additional insured) along with a Hold Harmless Indemnity Agreement for the insured to utilize with all of its sub-contractors. As a result, this eliminated any liability for loss due to worker injury from the sub-contractor’s employees.
The insured sub-contractor, and their insurer, saved millions of dollars from losses that rightfully belonged to the first level of subcontractor because of our analysis and subsequent recommendation. The client was most appreciative and holds SCM in the highest regard.