Primary Casualty Claims Advantages
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- Ruby Pope
- 10 years ago
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1 Primary Casualty Claims Advantages Results Focused Professionals A highly experienced claims team with decades of experience drives better outcomes. Built on years of experience, AIG has developed an unparalleled claims organization committed to fast, cost-efficient claims resolution. Supported by innovative technology and the financial strength of a world-leading property casualty insurer, our claims professionals are well equipped to deliver superior claims service and help clients successfully mitigate losses.
2 Enhancing the Competitive Position of our Clients AIG s seasoned claims team draws on first-hand knowledge of local risks, business practices, and the legal and regulatory environment. These dedicated professionals ensure clients receive consistent claims handling outcomes in whichever industry, or jurisdiction, they operate. Dedicated domestic casualty claims network of approximately 2,000 professionals 21 workers compensation offices, 4 divisional casualty offices and 3 complex casualty offices Nearly 1,000 workers compensation technical staff deployed in 26 states operating in a fully paperless environment Claims adjusters average more than 14 years of experience Designated adjusters assigned to each account In 2013, AIG paid $2.5 billion in employee injury claims and $760 million in primary casualty claims in the U.S. and Canada. Improving Medical Outcomes to Reduce Costs Reducing workers compensation costs starts with thoughtfully managing the cost of medical treatment. This means breaking inefficient patterns of care, controlling pharmaceutical costs and committing to effective treatment standards and guidelines. At AIG, we re doing just that. With a tightly controlled system of medical care delivery, AIG can help lower clients medical costs, speed case resolution and reduce overall claim costs. According to the National Council on Compensation Insurance (NCCI), medical costs account for 56% of the average workers compensation lost time claim. At AIG, our workers compensation claims average 44% in medical costs, 12 points below the industry average. Workers Compensation Lost Time Claims Costs Indemnity 44% Industry 56% 56% Average AIG 44% Medical Costs
3 Productivity Edge A Suite of Managed Care Services AIG s proactive claims programs aim to improve ultimate healthcare outcomes and return injured employees to work and to their families sooner. Productivity Edge is an innovative suite of managed care services that focuses on employees treatment and productivity and employers profitability. By targeting several key medical management areas, AIG takes aggressive action to get workers the right care at the right time. These managed care services help employers reduce medical expenses and better control indemnity costs. The Opioid Epidemic According to a study released in 2013 by the NCCI, opioid prescription drugs represent nearly 25% of all workers compensation pharmacy costs.
4 The Productivity Edge Approach The results described below are based on AIG claims data (excluding claims administered by third-party administrators). Opioid Management Utilizing pharmacy network data, medical guidelines and established triggers, AIG nurse case managers identify high-risk opioid prescriptions and alert the treating physicians. > 75% of cases lead to a change in prescription or treatment, with an impact on claim costs of more than $700 million over 10 years Pre-Injury Management Pre-injury consultants help clients reduce costs and return injured employees to productive employment by creating a workplace that accommodates modified duty positions, implementing successful early return to work programs and maximizing PPO utilization. > At 67% of PPO utilization, savings average 7% below fee schedule Outcomes-Based Network AIG can leverage a tailored network of doctors across key states that have expertise in treating workers compensation claimants and are committed to providing better and more cost-effective medical treatment. > When using this network, overall costs are 35% less, 42% of injured worker s return to work faster, and 63% have less major surgery Medical Expense Management A range of services help control medical costs, including a Pharmacy Benefit Management Program with over 60,000 preferred pharmacies, easy-to-use online medical provider networks and negotiation of complex medical bills conducted by Registered Nurses. > The Pharmacy Benefit Management Program saves over 50% on pharmacy bills Utilization Management Proven methodologies, including pre-certification and peer reviews, are used to validate healthcare on the basis of appropriateness, quality and necessity of treatment. > Utilization management has saved $74 million, with a 54% impact on nearly 75,000 cases Telephonic Case Management Registered Nurses facilitate early intervention and medical coordination among the client, employee and physician to ensure timely and appropriate treatment. > Lost time claims that use Telephonic Case Managers average 18% overall savings Provider Bill Audit Medical bills are audited for accuracy and compliance with state fee schedules to help ensure all treatment rendered is appropriate and within medically accepted parameters. > Audited bills are reduced by 50% on average Non-Network Provider Bill Negotiation AIG offers audit and negotiation services for clients non-network provider bills as well, helping reduce medical bills regardless of provider. > Negotiated bills average 19% savings
5 AIG s Staff Counsel attorneys average 24 years of practice and are strategically located in 29 offices across 22 states. Customized, Cost-Saving Resources Robust Litigation Management Infrastructure When more than 50% of our liability claims staff is comprised of attorneys with decades of experience managing a wide array of casualty cases, AIG is uniquely positioned to protect our clients interests. Our exceptional legal services hone advanced litigation strategies, test defense tactics and engage appropriate resources to help achieve the most effective claim resolutions with a long record of success. Expert In-House Staff Counsel With approximately 240 attorneys across 29 offices nationwide, AIG s experienced, in-house defense attorneys achieve winning verdicts above the national average and litigation costs well below those of outside counsel. Partnership of the Nation s Leading Law Firms AIG teams up with expert resources around the country, from investigators and forensic specialists to outside attorneys, allowing us to act quickly and skillfully when and where our clients need them. Alternative Dispute Resolution (ADR) Through the strategic use of flexible mediation and arbitration processes, where available, AIG helps control defense expenses and achieve faster claim resolutions. No Fee Global Recovery on Your Behalf A dedicated unit focuses solely on the subrogation of claims to successfully recover expenses on our clients behalf, resulting in a direct reduction in paid losses. Global Recovery received 32,000 referrals exceeding $920 million in recovery for AIG clients in 2013.
6 Technology that Makes Your Job Easier Advanced Injury Analytics New technology that helps us accelerate an injured worker s recovery time and return to work potential. This technology enables us to match the most challenging cases with the most experienced adjusters, resulting in early assessment of a claim, more contact with the injured worker and better tracking of medical data to achieve better claim outcomes. iclaims A state-of-the-art paperless claims system that immediately routes documents to the appropriate person, removing administrative burdens and empowering AIG professionals to focus more time on adjusting claims and serving client needs. RiskTool Advantage A web-based risk management tool, designed exclusively for AIG clients, which provides complimentary access to training resources, sample safety policies and risk guides, and a global risk library of over 10,000 links to references, regulations and standards across industries. IntelliRisk An award-winning system that makes detailed claim information available in real-time, allowing clients and brokers to monitor claim activity, view adjustor activity notes and create reports that include in depth trending analysis in minutes. Used by over 28,000 clients, IntelliRisk has won several awards, including Advisen s Best Bundled Claim System in 2013.
7 American International Group, Inc. (AIG) is a leading international insurance organization serving customers in more than 130 countries and jurisdictions. AIG companies serve commercial, institutional, and individual customers through one of the most extensive worldwide property-casualty networks of any insurer. In addition, AIG companies are leading providers of life insurance and retirement services in the United States. AIG common stock is listed on the New York Stock Exchange and the Tokyo Stock Exchange. Additional information about AIG can be found at YouTube: LinkedIn: AIG is the marketing name for the worldwide property-casualty, life and retirement, and general insurance operations of American International Group, Inc. For additional information, please visit our website at All products and services are written or provided by subsidiaries or affiliates of American International Group, Inc. Products or services may not be available in all countries, and coverage is subject to actual policy language. Non-insurance products and services may be provided by independent third parties. Certain property-casualty coverages may be provided by a surplus lines insurer. Surplus lines insurers do not generally participate in state guaranty funds, and insureds are therefore not protected by such funds.
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