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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.
Marjorie Segale began her career as a commercial insurance broker in Northern California and currently acts as a risk and insurance consultant with more than thirty -five years of experience in this field. She provides a wide variety of risk and insurance consulting services to commercial enterprises, insurance agents, brokers as well as insurance companies,…
James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies…
As insurance professionals, we are often so busy serving our clients that our writing and publishing take a back seat to our practice. Consistent publication keeps us in the public eye and allows us to rank higher on Google.
Ms. Leonhardi is a highly accomplished claim professional with proven success in both insurance and reinsurance claim management. Presently, she owns and operates two claim management services: Puget Sound Claim Consulting (PSCC) and Puget Sound Risk & Insurance Consulting (PSRIC), both based in Seattle, Washington. Ms. Leonhardi provides expert witness testimony on claim handling industry…
Peter Marchel is President and Founder of Marchel & Associates Risk Consulting. Types of the services offered: Risk review and consulting, broker review and selection, Â insurance policy review, analysis, and placement, program development, insurance management issues, policy enforcement, claims advocacy and expert witness testimony. Peter has more than 24 years experience in Legal…
Dale is a 35+ year veteran of the insurance industry, from an underwriter trainee to president of an insurance company. Along the way, he was also an officer at 2 reinsurance companies for 14 years. The reinsurance experience provided an exceptionally broad view of the industry, dealing with numerous insurance company clients in standard lines,…
Mr. Deimling brings a unique set of skills and abilities to each assignment. He is well versed and competent in a variety of fields. This unique combination of hands on learning, formal training, volunteer and civic involvement coupled with life experiences provides the client a solid return for their consulting investment. He has been in…
With over 30 years experience, Mr. Miltenberger has worked on the brokerage and company side of the insurance industry. He has extensive expertise in both the life and health and property and casualty space. His has proven ability to leverage his knowledge, relationships and experience on behalf of his clients issues. He also has an…
