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BUSINESS
ADVISORY
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Claims Management
Claims Management is comprised of consultation, audits, arranging service agreements, coordinating special handling instructions, and aggressively negotiating reserve reductions.
Combining experience and advocacy, One Risk Group, LLC, provides clients with support that ensures the insurance products we negotiate respond as intended without delay and disruption.
Effective Workers’ Compensation claims management can reduce both direct and indirect costs; costs associated with the injury itself and those associated with the administration of the claim and loss of productivity. One Risk Group, LLC structures a customized plan that provides clients with support to minimize the impact of claims.
- Proactive review and monitoring of new claims
- Review of prior years’ claims that have an impact upon current or future program costs and experience modification
- Consultation and strategy with problematic or questionable claims including assistance with ensuring proper investigation
- Critical claims reserve review prior to WCIRB and NCCI Experience Modification calculations
- Experience Modification projections that help clients budget for the future
- Assistance in selection and review of Occupational Medical providers and networks
- Assistance with implementation of first aid and return to work /transitional work programs
- Coordination of claims review meetings
- Loss analysis and trend reports
- Special claims handling instructions
- Structuring service agreements
- Coordination with short term and long term disability
Each One Risk Group, LLC service team is responsible to oversee every stage of Property & Casualty claims to ensure the carrier's actions are expeditious and in the client's best interest. Our internal diary system allows for tracking and monitoring as changes and developments occur.
Our Property & Casualty Claims services include:
- 24 hour claims reporting
- Negotiate special claims handling instructions
- Manage claims reporting process to ensure comprehensive claim data is submitted, resulting in the most favorable results
- Working with adjusters to ensure timely response and prompt claim resolution
- Reviewing reserves for appropriateness based on the type and severity of the claim
- Regular status reports through the life of the claim
- Advocacy when coverage is questionable or in dispute
- Pursuing subrogation of claims
- Loss trend review for risk management program improvements
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