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Third Party Claims Management

Third Party Claims Management

Today, many organizations are reducing their insurance premiums by taking advantage of self-insurance and higher liability deductibles as an alternative to the traditional insurance policy. With this model, working with an experienced Third-Party Administrator (TPA) who provides technical and administrative services is a smart choice.

The Third Party Claims Management, Administration and Processing practice is capable of providing expertise for the handling and auditing of casualty, property, professional liability and mass tort claims throughout the United States and internationally.

The claims staff handles first and third party multi-state accounts for major insurers and syndicates, including exposures for national companies under their Self Insured Retentions (SIRs). As a fully licensed TPA, the practice utilizes a state-of-the-art online claims administration system, offering clients 24/7 access to financial information, documents and claims notes.

Services include:
  • Technical handling of primary claims for an insurance carrier or company with an SIR to include administration of a loss fund on behalf of the client, issuance of indemnity and expense payments, monthly reconciliation of the loss fund and monthly loss reporting
  • Management of Excess and Surplus Lines claims, and all aspects of run-off books of business
  • Technical and administrative handling of mass tort claims
  • Auditing of TPAs, SIRs, and erosion of aggregates
  • Arbitration and litigation support including expert witness testimony

SAMPLE ENGAGEMENTS:

Run-off Book of Business Investigated

Alan Gray LLC was assigned the handling of a run-off book of business consisting of several hundred open claims files involving complicated commercial trucking liability, professional liability and general liability exposures. These files had not been properly handled and were grossly under-reserved. An initial audit performed by Alan Gray LLC consisted of reviewing every open file. Within 30-60 days, all indemnity and expense reserves were adjusted to the proper levels based on this audit. Alan Gray LLC claims expertise resulted in promptly expediting the resolution of the vast majority of the open claims by aggressively working with defense counsel and diligently pursuing settlement conferences and mediations throughout the United States. The outstanding claims were reduced to a minimum number in approximately 2½ years resulting in extensive savings on the money that was projected to be incurred by the client’s actuaries.  

Indemnity Settlements and Expense Billings Related to Asbestos Exposures

Working for one insured, Alan Gray LLC was responsible for processing indemnity settlements and expense billings for 8-12 different insurers related to asbestos exposures. The processing consisted of correctly allocating the indemnity settlements and payments to various years of coverage; securing the funds from 12 carriers to pay the settlements and expenses; and issuing checks for payment. In addition, time-sensitive quarterly in-house audits of claims submissions from various plaintiff law firms were conducted under an administrative settlement agreement to ensure the submissions were in compliance with the agreement. Detailed and accurate results were delivered to coordinating counsel for the insurers, allowing them to promptly collect substantial money from their reinsurers.