Wells Fargo Insurance Services Claim Consulting Capabilities

Transcription

1 Wells Fargo Isurace Services Claim Cosultig Capabilities

2 Claim Cosultig Claims are a uwelcome part of America busiess. I a recet survey coducted by Fulbright & Jaworski L.L.P., large U.S. compaies face a average of 350 pedig lawsuits. Regardless of the size of your compay, you will experiece claims either resultig from the actios of your employees, the actios of others, atural hazards, ecoomic, or regulatory factors. While loss cotrol programs ca help reduce ad mitigate claims, they will ever elimiate claims completely. For this reaso, it is importat that compaies utilize claim maagemet practices ad have access to professioals with experiece i claim maagemet, ivestigatio, isurace egotiatios, accoutig, legal, ad claim loss aalysis. Without the proper claim maagemet processes i place, compaies ca suffer exteded recovery periods ad reduced recoveries, excessive legal ad direct claim costs, icreased isurace premiums, ad possibly deial of coverage. Wells Fargo Isurace Services has the people, as well as the kowledge ad experiece, ecessary to aswer difficult claim maagemet questios ad to assist our customers i developig effective claim maagemet processes from pre-evet to post-evet. Our Approach Wells Fargo Isurace Service s first goal is to uderstad your busiess, its uique exposures, ad your maagemet philosophy regardig claims ad risk. Secod, we use our experiece to work with you to tailor a claim maagemet program that satisfies your eeds. Successful claim maagemet begis before a loss eve occurs. I the pre-evet phase, we work with you to make sure the program is what you eed, ad i the post-evet phase, we work to make sure the program rus smoothly ad satisfies performace objectives.

3 Pre-Evet Claim Maagemet Plaig Assist customers i developig ad ehacig claim maagemet programs ad processes based upo busiess eeds, loss history, ad maagemet philosophy. (Where applicable, develop specific programs ad procedures to address customer s uique eeds ad assure the effective maagemet of claims, i.e. disability maagemet, retur to work, ad litigatio maagemet) Evaluate claim maagemet optios such as isured plas, third party admiistratio programs, ad self-admiistered programs Assess third party admiistrators based o specific criteria to determie appropriate service providers Develop ad revise special accout istructios for isurers ad/or third party admiistrators to assure proper claim hadlig procedures ad processes, icludig reserve advisories, settlemet authority, litigatio guidelies, ad other services Create a desigated adjustig team to improve claim commuicatio ad maagemet Develop performace objectives ad measuremet tools to evaluate isurers ad/or third party admiistrators performace ad reduce claim costs Post-Evet Claim Maagemet Services Assist customers i evaluatig claims ad maximizig isurace recoveries Provide day-to-day claim advice ad assistace to customers, icludig resolvig ay claim hadlig issues that may arise Advocate o the customer s behalf o all coverage issues, icludig reservatio of rights ad coverage deials Coduct claim audits to evaluate isurers ad/or third party admiistrators performace relative to claim hadlig best practices Coduct claim reviews to assure that isurers ad/or third party admiistrators are properly maagig claims ad aggressively pursuig resolutio Assist i the timely resolutio of the claim, icludig egotiatig coverage issues, ad if ecessary, escalatig the matters to seior maagemet at the carrier Perform quatitative loss aalysis, icludig loss triagles to idetify claim treds ad opportuities for program improvemet

4 Liability Claim Cosultig Automobile liability Premises liability Products liability Fiacial ad professioal liability (D&O ad E&O) Liability claims make up what may Americas refer to as the ever expadig tort system. I fact, accordig to Tillighast- Towers Perri, the U.S. tort system will icrease by approximately $11 billio through 2008 to $280 billio. Today, tort costs equal $886 per U.S. citize, compared with $12 i With this type of growth, the questio becomes, How ca compaies better maage their tort liability? At Wells Fargo Isurace Services, our focus is to parter with you to develop solutios that ca lower your claim costs, improve your liability experiece, ad impact your bottom lie. Pre-Evet Liability Claim Plaig Review isurig agreemet, edorsemets, ad exclusios to determie the extet coverage is applicable to loss exposures Review loss otificatio requiremets ad establish claim evaluatio ad otice process Review settlemet ad pael cousel requiremets Work with the customer o programs that ivolve sigificat claim frequecy to idetify claim mitigatio strategies, special accout istructios, ad measure third party admiistrator performace Develop performace objectives ad measuremet tools to evaluate isurers ad/or third party admiistrators performace ad reduce claim costs Post-Evet Liability Claim Services Advise the customer as to coverage ad coordiate the timely reportig of claims to all isurers Assist the customer i day-to-day claim issues, icludig request for additioal iformatio Advocate o customer s behalf o all coverage issues, icludig reservatio of rights ad coverage deials Assist i the timely resolutio of the claim, icludig egotiatig coverage issues, ad if ecessary, escalatig the matters to seior maagemet at the carrier Coduct claim audits ad reviews to esure proper claim resolutio o programs that ivolve sigificat claim frequecy Our Commitmet Wells Fargo Isurace Services is committed to doig what we do best to support you i doig what you do best ruig a profitable, growig busiess. We do this by puttig our uique skills ad experiece to task to provide you with specialized services directed at moitorig ad cotrollig claims, lowerig claims costs, ad reducig your isurace premiums.

5 Property Claim Cosultig Wells Fargo Isurace Services strives to idetify, assess, ad develop strategies to mitigate our customers loss exposures. We kow that your busiess ad risks are uique. Therefore, our goal is to structure a custom property claim maagemet program to satisfy the uique eeds ad objectives of your busiess. Pre-Evet Property Claim Plaig Establish procedures ad resposibilities for gatherig ad processig claims iformatio, icludig protocols for reportig claims ad first respose Establish agreeable isurer claim service team o a pre-evet basis Assist the isurer s claim team i becomig familiar with the customer s busiess ad exposures prior to the loss Assist the customer i uderstadig claim procedures ad processes, ad applicable coverages afforded uder the existig policy form Post-Evet Property Claim Services Implemet agreed upo post-loss claim procedures Assist i the preparatio ad submissio of the customer s claims to the isurer Idetify ay cosultig or vedor services that may beefit the customer Advise ad assist i coordiatig ispectios amog all parties Advocate o the customer s behalf o all coverage ad loss measuremet issues Assist i developig a agreed upo method of measurig ad documetig all aspects of the claim Review ad explai ay potetial coverage limitatios Secure partial paymets (if ecessary) i a maer satisfactory to the customer Assist i the timely resolutio of the claim

6 Workers Compesatio Claim Cosultig Workers compesatio remais a key cost driver for may employers. While workplace ijuries ad illesses have dropped from 7.1 (per 100 full-time workers) i 1997 to 4.6 i 2005, ad idemity cases have declied from 4.1 cases per 100 full-time workers i 1990 to 2.4 cases per 100 employees i 2005, the cost of idemity claims cotiues to rise accordig to the Bureau of Labor Statistics. Not surprisigly, the primary reaso for this icrease has bee medical costs. Accordig to NCCI, over the five-year period, , workers compesatio medical costs rose a average of almost 10 percet while the medical care CPI rose 4.4 percet. This has bee fueled by the icreased use of ewer ad more expesive prescriptio drugs ad a sigificat icrease i the cost ad utilizatio of hospital services, particularly for critical care ad i the use of MRIs. A study by Liberty Mutual Isurace Cos. foud that the average prescriptio costs to workers compesatio isurers are roughly 75 percet more tha the same medicatio costs of a group health pla. Icreasig medical costs combied with a agig workforce ad the obesity epidemic will cotiue to make workers compesatio claims maagemet a critical issue. Wells Fargo Isurace Services will parter with you to develop solutios that ca lower your claim costs, improve your workers compesatio experiece, ad impact your bottom lie. Pre-Evet Workers Compesatio Claim Plaig Assist i the developmet of a effective workers compesatio program, icludig helpig with decisios regardig isured plas, third party admiistered plas, ad self-admiistered plas Participate i the selectio of third party admiistrators based o criteria, icludig etworks, iformatio systems, accout flexibility, staff qualificatio, compliace ad cotrols, pricig, ad service value Develop ad/or revise special accout istructios with isurers ad/or third party admiistrators to assure proper claim hadlig procedures ad processes, icludig reserve advisories, settlemet authority, ad litigatio guidelies Create a desigated service team to improve commuicatio ad the claim maagemet processes Implemet disability, retur to work, ad litigatio maagemet guidelies to assure the effective maagemet of claims Parter with loss cotrol ad safety for pre-loss strategizig ad plaig Educate ad trai maagers, supervisors ad/or employees o claim reportig, workers compesatio process, beefits, related cost, ad ewly adopted rules ad regulatios Develop performace goals ad measuremet tools to evaluate third party admiistrator performace ad to improve loss history Post-Evet Workers Compesatio Claim Services Provide day-to-day claim advice ad assistace to customers, icludig resolvig ay claim hadlig issues that may arise Elicit a pro-active claim hadlig approach from isurers ad/or third party admiistrators ad their claim adjusters Develop actio plas o complex claims, high exposure claims, or high profile claims ad provide claim status reports o a cotiuig basis Moitor claim reservig practices ad egotiate claim reserve levels to reflect a probable, ultimate outcome Coduct claim audits to evaluate third party admiistrators performace relative to claim hadlig best practices Coduct claim reviews to assure that claims are beig properly maaged ad resolutio is beig aggressively pursued Evaluate ad follow up o possible fraudulet claims ad/or compesability issues Coordiate ad review medical cost cotaimet programs Aalyze loss history to idetify claim patters ad treds i order to assist i developig claim reductio programs ad strategies Provide iformatio regardig curret legislative tred ad chages, as they relate to workers compesatio

7 Cotact Us Today Or Visit Us At: wellsfargo.com/wfis Wells Fargo Isurace Services Northwest, Ic. Tom Korelis Vice Presidet 520 Pike Street #2000 Seattle, WA Office Cell Fax Wells Fargo Isurace Services Commercial Isurace Employee Beefits Persoal Lies Admiistrative Services Excess & Surplus Lies Idustry Specialties Reisurace Iteratioal Coverage RT C