We establish performance standards with our customers, and we grade our claim adjusters on how well they achieve those standards. Upon request, ASC can provide the customer with a copy of the report card that benchmarks items such as timely claim entry, thorough contact with the customer and injured party, development of an action plan, and claims resolution.
Our employee incentive program is then tied to these report cards in order to promote quality performance. ASC claim adjusters are financially rewarded for achieving program benchmarks. this effective program has consequently reduced our customer’s average total incurred and claims life span.
ASC’s senior staff members regularly conduct on-site audits in order to ensure quality and consistent performance.
ASC has created a Quality and Professional Standards Unit that is responsible for the design and implementation of service standards to maintain high quality service and to ensure claims move smoothly toward resolution. This formalizes ASC’s commitment to quality service and claims resolution.
Claims Management Communication
Communications can make or break a claims management program. ASC devotes extensive efforts and resources to ensure all concerned parties remain informed throughout the workers' compensation and liability claims management process. We maintain that:
We keep you apprised of all activity on open claims, offering recommendations and direction when appropriate. Additionally, ASC adjusters, account managers, and senior management meet regularly with you to review files and formulate strategies for effective claim resolution.
ASC adheres to carrier litigation guidelines utilized on high deductible programs. We work with our self insured customers to set up litigation management programs that are responsive.
For example, the Nevada Public Agency Insurance Pool (NPAIP) summarized the success of their program as follows:
NPAIP has selected a panel of approved defense counsel to handle all litigation. Members do not defend cases involving potential coverage in house. Defense counsel has been selected based upon expertise with public entities and the area of law, especially with respect to civil rights litigation. Many of the attorneys on the approved panel have been defending cases for NPAIP since its inception. Approved panel counsel agrees to adhere to preset reporting and billing practices, and these practices are closely monitored in every case. NPAIP and ASC are actively involved in litigation by attending depositions, settlement conferences, and maintaining close contact with defense counsel. NPAIP's litigation policy is to attempt to resolve cases involving liability early on, if possible. NPAIP draws a line in cases it chooses to defend which, over time, has successfully sent a message to the plaintiff's bar. Defense counsels are periodically audited for overall adherence to reporting, and billing requirements are managed accordingly.
The secret to any litigation management strategy is outlined in bold above. Better results are only possible if the adjuster has time to be involved with counsel. If caseloads are too high, these functions are left to the discretion of counsel without the valuable input of the adjuster.