Claims & Litigation

Contrary to what some insurance companies may believe, businesses don’t buy insurance the same way an individual buys life insurance. They do expect to collect before they are dead!

In claims management, “time is of the essence”. The survival of the business may depend on how fast the insurance policy responds to the loss. The same way contractual risk management and safety management are two of the most important pre-loss activities; claims management is the most important post-loss activity. Our claims and litigation web-based application helps the risk manager process each claim, assuming that will end up in litigation (worst case scenario), and work closer with the third party administrator, the in-house claims department or the insurance carrier claims department to control the total loss cost. Regardless of the type of claim, each investigation is conducted as if the claim would end up in litigation. For example, witnesses’ names are sent to HR to avoid “accidental” termination of key witnesses. In addition, the application includes tools for loss estimation, loss development and settlement negotiations.

Insight Claims© allows the risk manager to separate claims where the company is the “claimant” or the “other party” receiving the claim. The system also breaks the claims management process into three sections: Investigation, Administration and Litigation; providing screens to enter information in each one. Below some of the information that can be found in each of these screens:

  1. Investigation
    • Claim date, name, number and description
    • Claim’s possible cause
    • Witness List
    • Claims Details screen: Auto, WC, CGL, Cargo, and others
    • Loss Estimator
  2. Administration
    • Claim Carrier Number
    • Claim’s Action Plan
    • Task List
    • Insurance Policies
    • Loss Development Screen
  3. Litigation
    • Litigation Status
    • Suit Action Plan
    • Task List
    • Deposition Candidates
    • Litigation Calendar to set up email alerts
    • Company Legal Team
    • Other Party Legal Team
    • Claim Negotiations and Settlement Screen

Below is the list of some of the documents that can be found on each of these INSIGHT Claims© documents screens:

  1. Investigation
    • Incident/Accident Report
    • Pictures
    • Witnesses statements in written format (pdf) or digital voice recording (wma)
    • Police report
  2. Administration
    • Repair quotes for property damages (auto, buildings, equipment, etc.)
    • Records from hospital, clinics or other medical service providers from injuried workers
    • Insurance carrier communication (letters, e-mails, settlement offers, etc.)(Note: we will check if the claim will be paid by :1) insurance carrier, 2)Third party, 3)Client )
    • Billing from service providers
    • Payroll records, job applications and other documents from the injuried worker’s file (required by State Workers Compensation law)
  3. Litigation
    • Summons and other initial court documents.
    • Subpoenas
    • Request for Productions
    • Request for Interrogatories
    • Correspondence (letters, e-mails, voice messages, etc.) from/to Plaintiff attorneys
    • Correspondence (letters, e-mails, voice messages, etc.) from/to Defense attorneys
    • Depositions in written format (pdf) or digital voice recording (wma) or in video format (wmv)
    • Settlement offers written or verbal (if recorded).