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Mr. Bushnell is a Certified Public Accountant with over 20 years of experience providing Forensic Accounting services through national and global professional services firms. Know as the “numbers guy” his professional expertise covers Business Interruption Claims, Economic Damage Analysis, and Fraud Investigations. Mr. Bushnell has advised clients in mediation, arbitration and appraisal as a third…
•Wrongful Designation by Thomas M. Braniff, JD, CPCU and Robert P. Gaddis, JD;
•The Essential Bookshelf for Expert Witnesses by Kevin Quinley, CPCU, ARM, AIC;
•The 411 on Becoming an Expert Witnesses by Elise M. Farnham, CPCU, ARM, AIM, CPIW;
•Working as an Expert Witnesses by Douglas R. Emerick; and
•“Be Careful What You DON’T Ask For” By Bill Wilson, CPCU, ARM, AIM, AAM.
“Diminishing limits policies create a host of potential problems for insurance company claim departments. As is well known the insurance industry has long been plagued with “nuisance” claims. While in some instances insurance companies make quick settlements of nuisance claims to avoid defense cost expenditures, in others, insurers will attempt to resist such claims to avoid setting a precedent, thereby sending a message to the plaintiff’s bar that nuisance claims will not be honored. Considering that defense costs are deducted from the policy’s aggregate limits, either course of action places an insurance company in a difficult position. … “
The claims audit is the anathema of day-to-day claim operations. Nothing is more disruptive. Yet, if properly defined, nothing is more informative and helpful in improving a claim management program. This article will examine the need for a regular auditing program and provide a recipe for a three-dimensional approach to the process in order to maximize the accuracy of the audit results.
The need to conduct regular claims audits has already been widely discussed. With the magnitude of self-insured claims programs (including self-funded programs) and the millions of dollars spent on claim administration fees, what better way to verify whether the money spent has been justified or wasted? In essence, an audit of closed and open claims should accomplish several things.